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Monitoring Lung Function with Electrical Impedance Tomography in the Intensive Care Unit
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Early pH Change Predicts Intensive Care Unit Mortality.

Sujay Samanta1, Ratender Kumar Singh1, Arvind K Baronia1

  • 1Department of Critical Care Medicine, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow, Uttar Pradesh, India.

Indian Journal of Critical Care Medicine : Peer-Reviewed, Official Publication of Indian Society of Critical Care Medicine
|November 9, 2018
PubMed
Summary

Early changes in pH levels may predict intensive care unit (ICU) mortality better than other metabolic markers. Monitoring the rate of pH change in critically ill patients can improve survival predictions.

Keywords:
Metabolic acidosismortalitypH change

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Area of Science:

  • Critical Care Medicine
  • Intensive Care Unit (ICU) Research
  • Metabolic Disorders

Background:

  • Metabolic acidosis is a significant risk factor for mortality in critically ill patients.
  • Early intervention for metabolic acidosis is hypothesized to improve patient outcomes.

Purpose of the Study:

  • To investigate the impact of early pH changes on 28-day mortality in ICU patients.
  • To determine if the rate of pH correction is a better predictor of mortality than other metabolic indices.

Main Methods:

  • Prospective observational study of 104 adult ICU patients with metabolic acidosis (pH 7.0 to <7.35).
  • Recorded arterial blood gas parameters (pH, PaCO2, HCO3-, lactate, etc.) at 0, 6, and 24 hours.
  • Assessed 28-day ICU mortality as the primary outcome.

Main Results:

  • 65.4% of patients died by day 28.
  • Nonsurvivors exhibited higher vasopressor index, lactate, and lower pH.
  • A pH change of ≥1.16% within 24 hours was the best predictor of 28-day survival (AUC 0.72).

Conclusions:

  • Metabolic acidosis is linked to increased ICU mortality.
  • The rate of pH change is a more effective predictor of ICU mortality than traditional metabolic indices like bicarbonate or lactate.