Chaiyakulsil Chanapai, Mueanpaopong Papope, Lertbunrian Rojjanee, Chutipongtanate Somchai
Division of Pediatric Critical Care, Department of Pediatrics, Faculty of Medicine, Thammasat University, Bangkok, Thailand.
Department of Pediatrics, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand.
BMC Res Notes. 2019 Nov 9;12(1):742. doi: 10.1186/s13104-019-4770-6.
Physicochemical approach such as strong ion difference provides a novel concept in understanding and managing acid-base disturbance in patients. However, its application in pediatrics is limited. This study aimed to evaluate a correlation between the physicochemical approach and blood gas pH for acid-base determination in critically ill pediatric patients.
A total of 130 pediatric patients were included, corresponding to 1338 paired measures for analyses. Of these, the metabolic subgroup (743 paired measures) was defined. Among physicochemical parameters, the effective strong ion difference showed the best correlation with the blood gas pH in the whole cohort (R = 0.398; p < 0.001) and the metabolic subgroup (R = 0.685; p < 0.001). Other physicochemical parameters (i.e., the simplified and the apparent strong ion difference, the strong ion gap, and the sodium chloride gap) and the traditional measures (standard base excess, lactate, chloride and bicarbonate) also showed varying degrees of correlation. This study revealed the positive correlation between physicochemical parameters and the blood gas pH, serving as a connecting dot for further investigations using physicochemical approach to evaluate acid-base disturbance in pediatric population.
诸如强离子差等物理化学方法为理解和处理患者的酸碱平衡紊乱提供了一个新的概念。然而，其在儿科中的应用有限。本研究旨在评估物理化学方法与血气pH值之间的相关性，以用于危重症儿科患者的酸碱平衡测定。
共纳入130例儿科患者，对应1338对用于分析的测量值。其中，定义了代谢亚组（743对测量值）。在物理化学参数中，有效强离子差在整个队列（R = 0.398；p < 0.001）和代谢亚组（R = 0.685；p < 0.001）中与血气pH值显示出最佳相关性。其他物理化学参数（即简化强离子差、表观强离子差、强离子间隙和氯化钠间隙）以及传统指标（标准碱剩余、乳酸、氯离子和碳酸氢根）也显示出不同程度的相关性。本研究揭示了物理化学参数与血气pH值之间的正相关关系，为进一步采用物理化学方法评估儿科人群的酸碱平衡紊乱提供了一个连接点。
