Research on the distribution of acid-base disturbance(ABD)in ICU patients and its correlation with mortality rate
Luo Yanni
Li Ruohan
Li Jiamei
Zhang Jingjing
Hou Yanli
Gao Ya
Wang Xiaochuang
Wang Gang
Abstract：Objective To describe the occurrence of acid-base disturbance(ABD)in intensive care unit(ICU)patients and its relationship with clinical outcomes.Methods Adult ICU patients with serum albumin,pH,bicarbonate,PCO2,chloride,sodium,and potassium levels measured within 24 hours of admisson were included from the eICU database.The type of ABD was evaluated based on blood biochemical tests and arterial blood gas indicators.The prevalence of each disease in different ABD types and the incidence of each ABD type in different diseases were calculated.The differences in mortality rates among different ABD subtypes were calculated by using the chi-square test.Results A total of 13 363 patients were included.9 912 patients(74.2%)had ABD.Compared with patients without ABD,the ICU mortality rate(9.9%vs.18.9%,P<0.001)and in-hospital mortality(15.9%vs.25.9%,P<0.001)of patients with ABD were significantly increased.Among the overall ABD population,the prevalence of double ABD was the highest(53.0%),with respiratory acidosis+metabolic acidosis being the main type(31.2%).Regardless of the type of ABD,the prevalence of respiratory failure,shock,and sepsis ranked among the top three.Among the patients with respiratory failure,shock,sepsis,pneumonia and renal failure,respiratory acidosis combined with metabolic acidosis accounted for 34.1%,32.9%,31.3%,32.6%and 36.3%of the cases,respectively.Among the patients with respiratory failure,shock,sepsis and renal failure,the ICU mortality rates(38.2%,46.0%,38.7%,and 38.3%)and in-hospital mortality(48.8%,56.8%,50.0%,and 50.3%)of those with respiratory acidosis+metabolic acidosis+high anion gap(AG)acidosis were the highest.Conclusions The main type of ABD in ICU patients is respiratory acidosis+metabolic acidosis.Although the prevalence of respiratory acidosis+metabolic alkalosis+high AG acidosis is relatively low,the ICU mortality rates and hospital mortality rates of this type are the highest.In the acid-base management of ICU patients,it is essential to assess their acid-base status promptly,particularly to identify respiratory acidosis,metabolic alkalosis,and high AG acidosis as early as possible.
Keywords：Acid-base disturbanceMortality rateIntensive care uniteICU database
Publication Date：2025-10-10
Online Publishing Date：2025-11-07(First online date of this platform, not the publication date of the document)
Pages：8( 914-920,封3 )