Clinical analysis of alkalosis in 868 critically ill patients

Objective:To explore the types,characteristics and causes of alkalosis in critically ill patients.Methods:The clinical data,1 470 determinations of arterial blood gases and electrolytes in 868 critically ill patients were analyzed.Results:The types of alkalosis were ranked as following:respiratory alkalosis (868 determinations,45 44%),metabolic alkalosis (362 determinations,24 63%),respiratory alkalosis plus metabolic alkalosis (270 determinations,18 37%),triple acidbase disorders with respiratory alkalosis (102 determinations,6 94%),and respiratory acidosis plus respiratory alkalosis (68 determinations,4 63%).PaO 2 values below 8 kPa (1 kPa=7.5 mmHg) were obtained in 773 determinations (52.59%).The mechanism associated with the occurrence of alkalosis was multifactorial in these patients.Conclusions:Alkalosis occurred frequently in critically ill patients.The most common form was respiratory alkalosis with type Ⅰ respiratory failure.The primary disease might result in respiratory alkalosis and hypoxemia in patients with normal respiratory function,and incorrect treatment seems to be responsible for the occurrence of metabolic alkalosis.Triple acidbase disorders with respiratory alkalosis may frequently appear in critically ill patients with multiple organ dysfunction.