2003•Chinese Journal of Critical Care MedicineRequires access
Analysis of triple acid-base disturbances in critical ill patients
Ren Cheng-shan
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Abstract
Objective To improve the diagnosis and treatment of triple acid-base disturbance (TABD) in critical ill patients. Methods Clinical features , arterial blood gas and plasma electrolytes of 168 critical ill patients were analyzed. Results Of the total 168 patients , 121(72.0%) had TABD of respiratory alkalosis, 47(28.0%) had TABD of respiratory acidosis . pH7.45 was found in 92 patients (54.8%), and pH7.35 in 39 patients (23.2%). PaO 280 mmHg was found in 75 patients (44.6%) ,and PaO 260 mmHg in 41 patients (54.6%). The potential 〔HCO 3 -〕 increased in 113 patients (67.2%) and anion gap(AG)18 mmol was found in 168 patients. The mortality was 41.1% (69 patients). Conclusion TABD of respiratory alkalosis could be diagnosed when there appeared respiratory alkalosis, increased AG and potential〔HCO 3 -〕24+0.5×△PaCO 2+2.5. TABD of respiratory acidosis could be diagnosed when there were respiratory acidosis, increased AG and potential 〔HCO 3 -〕24+0.35×△PaCO 2+5.58.