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Study on acid-base disturbance in patients with post-traumatic multiple organ dysfunction syndrome
Chengshan Ren1, Guisheng Qian, Zhongjie Guo
1Department of Emergency, Xinqiao Hospital, Third Military Medical University, Chongqing 400037, China.
Summary
Acid-base disturbances (ABD) are common in patients with multiple organ dysfunction syndrome (MODS), with respiratory alkalosis and metabolic acidosis being most frequent. Early detection and management of ABD are crucial for improving outcomes.
Area of Science:
- Critical Care Medicine
- Nephrology
- Pulmonology
Background:
- Post-traumatic multiple organ dysfunction syndrome (MODS) is a critical condition with high mortality.
- Acid-base disturbances (ABD) are frequently observed in critically ill patients, but their specific patterns in MODS require detailed investigation.
Purpose of the Study:
- To classify the types and determine the incidence of acid-base disturbances in patients with post-traumatic MODS.
- To analyze the correlation between ABD and patient outcomes in MODS.
Main Methods:
- Arterial blood gas analysis and serum electrolytes were performed 675 times on 119 MODS patients.
- Classification of ABD included simple, double, and triple disturbances.
- Calculations included pH, anion gap (AG), and bicarbonate [HCO(3)(-)].
Main Results:
- ABD were present in 95.9% of analyses.
- Simple ABD occurred in 41.7%, double in 41.9%, and triple in 16.4%.
- Respiratory alkalosis (RAL) was most common (62.4%), followed by metabolic acidosis (MA) (51.3%), metabolic alkalosis (MAL) (35.1%), and respiratory acidosis (RA) (25.8%).
- ABD contributed to mortality in 66.4% of cases.
Conclusions:
- Early MODS may present with RAL, potentially progressing to MA or triple ABD.
- Maintaining electrolyte balance and treating primary diseases are essential for managing ABD in MODS.
- Intervention is necessary when pH falls outside the 7.20-7.50 range.