Metabolic acidosis
Conditions
Interventions
Upon admission to the ICU, demographic data, intraoperatively relevant data, SAPS 3 and data from laboratory tests were evaluated: arterial blood gases, lactate, serum sodium, chloride and albumin. Af
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Sponsors
Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo - HC- FMUSP
Hospital do servidor Público Estadual de São Paulo - HSPE/IAMSPE
Hospital do Câncer de Barretos
Eligibility
Age
18 Years to No maximum
Inclusion criteria
Inclusion criteria: Surgical patients (age = 18 years) admitted to the ICU consecutively during the study period and at least one of the following criteria: severe cardiorespiratory disease (presence of coronary artery disease, aortic surgery, chronic obstructive pulmonary disease, or stroke); cancer surgery with extensive resection (esophagectomy, total gastrectomy, liver resection, pancreatectomy, cystectomy or total colectomy); surgical time greater than 6 hours; severe polytrauma; Massive intraoperative blood loss (hematocrit < 20%); intraoperative circulatory shock (mean arterial pressure < 60 mmHg) requiring vasopressors; previous nutritional disorder; body mass index < 20; patients over 65 years of age with evidence of physiological limitation in at least one vital organ
Exclusion criteria
Exclusion criteria: Patients who stayed less than 24 hours in the intensive therapy ; patients with low life expectancy (cancer with no prospect of treatment); patients with liver failure - (child B or C); patients with renal insufficiency (creatinine clearance 126 mg/dL after perioperative 8-hour fasting
Design outcomes
Primary
| Measure | Time frame |
|---|---|
| Expected outcome 1: Patients with delta anion gap/delta bicarbonate values ??below 1.0 would have a worse outcome in the ICU with higher associated mortality and greater association with complications;Outcome found 1: Comparing the metabolic acidosis groups regarding complications that occurred in the ICU, the metabolic acidosis group without other disorders showed a greater association with cardiovascular complications (p = 0.001), mortality in the ICU (p = 0.03) and the sum of all complications during the period in the ICU (p = 0.021) | — |
Secondary
| Measure | Time frame |
|---|---|
| Expected outcome 2: Patients related to Delta AG/Delta Bicarbonate less than 1.0 are expected to show a greater association with negative excess base, higher intraoperative consumption of saline solution and higher chlorine values;Outcome found 2: The total amount of 0.9% saline solution received intraoperatively was evaluated according to the deltaAG/deltaBic classification, with a median of 1250 mL (750-2250) in patients with metabolic acidosis only with high AG, 3000 mL (1500- 4500) for patients with associated hyperchloremic acidosis and 2250 mL (2000-3000) for patients with associated metabolic alkalosis. The base difference showed a negative variation in admission to the ICU greater in patients with associated hyperchloremic acidosis in the amount of -7.8 versus -6.3 in patients with metabolic acidosis with high AG without associated disorders and -4.4 in patients with associated metabolic alkalosis. Chlorine had a value of 113.1±4.6 in patients with associated hyperchloremic metabolic acidosis, a value of 106.3±8.1 in patients with associated metabolic alkalosis, and a value of 111.1±7.1 in patients with metabolic acidosis with increased AG without associated disorder | — |
Countries
Brazil
Contacts
Public ContactPedro Menezes
Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo - HC- FMUSP
Outcome results
None listed