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Author Antonogiannaki, Elvira-Markela ♦ Mitrouska, Ioanna ♦ Amargianitakis, Vassilis ♦ Georgopoulos, Dimitris
Source World Health Organization (WHO)-Global Index Medicus
Content type Text
Publisher Elsevier
File Format HTM / HTML
Language English
Difficulty Level Medium
Subject Domain (in DDC) Social sciences ♦ Social problems & services; associations ♦ Social welfare problems & services ♦ Natural sciences & mathematics ♦ Chemistry & allied sciences ♦ Life sciences; biology ♦ Physiology & related subjects ♦ Biochemistry ♦ Natural history of organisms ♦ Technology ♦ Medicine & health ♦ Human physiology ♦ Pharmacology and therapeutics ♦ Diseases ♦ Manufacture for specific uses ♦ Precision instruments & other devices
Subject Domain (in MeSH) Eukaryota ♦ Organisms ♦ Nutritional and Metabolic Diseases ♦ Diseases ♦ Inorganic Chemicals ♦ Amino Acids, Peptides, and Proteins ♦ Chemicals and Drugs ♦ Diagnosis ♦ Investigative Techniques ♦ Analytical, Diagnostic and Therapeutic Techniques and Equipment ♦ Chemical Phenomena ♦ Biological Sciences ♦ Persons ♦ Persons ♦ Health Care Facilities, Manpower, and Services ♦ Health Care
Subject Keyword Discipline Emergency ♦ Discipline Medicine ♦ Acid-base Imbalance ♦ Diagnosis ♦ Bicarbonates ♦ Blood ♦ Water-electrolyte Imbalance ♦ Acid-base Equilibrium ♦ Complications ♦ Aged ♦ Aged, 80 And Over ♦ Anions ♦ Blood Gas Analysis ♦ Chlorides ♦ Cohort Studies ♦ Emergency Service, Hospital ♦ Female ♦ Humans ♦ Magnesium ♦ Male ♦ Middle Aged ♦ Models, Chemical ♦ Potassium ♦ Prospective Studies ♦ Serum Albumin ♦ Sodium ♦ Water-electrolyte Balance ♦ Journal Article ♦ Observational Study
Abstract BACKGROUND: The aim of this study is to evaluate the value of physicochemical, base excess (BE), and plasma bicarbonate concentration ([HCO3(-)]) approaches on the assessment of acid-base status in patients presented to the emergency department (ED). METHODS: Upon presentation at ED, patients whose arterial blood was deemed in need of analysis were studied. Arterial blood gases, serum electrolytes, and proteins were measured and used to derive [HCO3(-)], BE, anion gap (AG), AG adjusted for albumin (AGadj), strong ion difference, strong ion gap (SIG) and SIG corrected for water excess/deficit (SIGcor). In each patient the acid-base status was evaluated using the BE, [HCO3(-)], and physicochemical approaches. RESULTS: A total of 365 patients were studied. Compared with BE (n = 202) and [HCO3(-)] (n = 151), physicochemical approach (n = 279) identified significantly more patients with metabolic acid-base disturbances (P < .0001). Significantly fewer patients with unmeasured anions acidosis were identified with AGadj than with SIGcor (164 vs 230; P < .0001). On the basis of BE, 75 patients had normal acid-base balance, and 65 (87%) of them exhibited at least 1 hidden acid-base disturbance, identified by the physicochemical approach. The corresponding values with [HCO3(-)] approach were 108 and 95 (88%) patients. When patients with high AGadj were excluded, 44 patients with BE and 67 with [HCO3(-)] approach had normal acid-base status, and most of them exhibited at least 1 acid-base disturbance with the physicochemical approach, whereas 12 and 21 patients, respectively, had high SIGcor. CONCLUSION: Compared with the BE and [HCO3(-)] methods, the physicochemical approach has a better diagnostic accuracy to identify metabolic acid-base disturbances.
Description Author Affiliation: Antonogiannaki EM ( Intensive Care Medicine Department, University Hospital of Heraklion, Medical School, University of Crete, Heraklion, Crete, 71110 Greece. Electronic address: kantonogiannaki@gmail.com.); Mitrouska I ( Pulmonary Department, University Hospital of Heraklion, Medical School, University of Crete, Heraklion, Crete, 71110 Greece. Electronic address: mitrouska@med.uoc.gr.); Amargianitakis V ( Intensive Care Medicine Department, University Hospital of Heraklion, Medical School, University of Crete, Heraklion, Crete, 71110 Greece. Electronic address: vamargian@gmail.com.); Georgopoulos D ( Intensive Care Medicine Department, University Hospital of Heraklion, Medical School, University of Crete, Heraklion, Crete, 71110 Greece. Electronic address: georgop@med.uoc.gr.)
ISSN 07356757
Educational Role Student ♦ Teacher
Age Range above 22 year
Educational Use Reading ♦ Research ♦ Self Learning
Interactivity Type Expositive
Education Level UG and PG
Learning Resource Type Article
Publisher Date 2015-03-01
Publisher Place United States
e-ISSN 15328171
Journal The American Journal of Emergency Medicine
Volume Number 33
Issue Number 3


Source: WHO-Global Index Medicus