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Acid–base disorders evaluation in critically ill patients: we can improve our diagnostic ability

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Abstract

Purpose

To determine whether Stewart’s approach can improve our ability to diagnose acid–base disorders compared to the traditional model.

Methods

This prospective cohort study took place in a university-affiliated hospital during the period of February–May 2007. We recorded clinical data and acid–base variables from one hundred seventy-five patients at intensive care unit admission.

Results

Of the 68 patients with normal standard base excess (SBE) (SBE between −4.9 and +4.9), most (n = 59; 86.8%) had a lower effective strong ion difference (SIDe), and of these, 15 (25.4%) had SIDe < 30 mEq/L. Thus, the evaluation according to Stewart’s method would allow an additional diagnosis of metabolic disorder in 33.7% patients.

Conclusions

The Stewart approach, compared to the traditional evaluation, results in identification of more patients with major acid–base disturbances.

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Authors and Affiliations

  1. Critical Care Department, Hospital de Clínicas de Porto Alegre, Porto Alegre, Brazil

    Márcio Manozzo Boniatti, Paulo Ricardo Cerveira Cardoso, Rodrigo Kappel Castilho & Silvia Regina Rios Vieira

  2. Rua Angelo Segalla, 622, CEP 95070-420, Caxias do Sul, RS, Brazil

    Márcio Manozzo Boniatti

Authors
  1. Márcio Manozzo Boniatti
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  2. Paulo Ricardo Cerveira Cardoso
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  3. Rodrigo Kappel Castilho
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  4. Silvia Regina Rios Vieira
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Correspondence to Márcio Manozzo Boniatti.

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Boniatti, M.M., Cardoso, P.R.C., Castilho, R.K. et al. Acid–base disorders evaluation in critically ill patients: we can improve our diagnostic ability. Intensive Care Med 35, 1377–1382 (2009). https://doi.org/10.1007/s00134-009-1496-2

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  • DOI: https://doi.org/10.1007/s00134-009-1496-2

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