危重症患者酸碱平衡紊乱的评估：我们可以提高诊断能力。
Acid-base disorders evaluation in critically ill patients: we can improve our diagnostic ability.
作者信息
Boniatti Márcio Manozzo, Cardoso Paulo Ricardo Cerveira, Castilho Rodrigo Kappel, Vieira Silvia Regina Rios
机构信息
Critical Care Department, Hospital de Clínicas de Porto Alegre, Porto Alegre, Brazil.
出版信息
Intensive Care Med. 2009 Aug;35(8):1377-82. doi: 10.1007/s00134-009-1496-2. Epub 2009 Apr 15.
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.
目的
确定与传统模型相比，斯图尔特方法能否提高我们诊断酸碱紊乱的能力。
方法
这项前瞻性队列研究于2007年2月至5月在一家大学附属医院进行。我们记录了175例入住重症监护病房患者的临床数据和酸碱变量。
结果
在68例标准碱剩余（SBE）正常（SBE在-4.9至+4.9之间）的患者中，大多数（n = 59；86.8%）的有效强离子差（SIDe）较低，其中15例（25.4%）的SIDe < 30 mEq/L。因此，根据斯图尔特方法进行评估可使33.7%的患者被额外诊断为代谢紊乱。
结论
与传统评估方法相比，斯图尔特方法能识别出更多患有主要酸碱紊乱的患者。
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