Department of Critical Care, Hospital Nossa Senhora da Conceição, Porto Alegre, Brazil.
Department of Critical Care, Hospital de Clínicas de Porto Alegre, Porto Alegre, Brazil.
J Clin Monit Comput. 2022 Jun;36(3):817-822. doi: 10.1007/s10877-021-00713-0. Epub 2021 May 2.
To compare whether the diagnostic evaluation of metabolic acidosis can be improved by using a modified Story method compared to the traditional evaluation in a population of critically ill patients with shock. This prospective cohort study included shock patients admitted to the ICU of a tertiary hospital in Brazil between May 2018 and November 2019. We collected laboratory data necessary for traditional evaluation and the simplified Stewart's method. During the study period, 149 patients were included in the final analysis. Of the 17 patients with a normal SBE and AG, 13 (76.5%) presented with metabolic acidosis according to the modified Story assessment. Therefore, of the 149 patients included in the study, the traditional approach failed to identify metabolic acidosis that was identified by the modified Story assessment in 13 (8.7%) patients. In addition, the determination of the severity of metabolic acidosis also differed between the two methods by a mean of - 7.8 mEq/L. We found that a modified Story method can identify and quantify metabolic acidosis in patients with disorders that were not revealed by the traditional approach.
比较改良 Story 法与传统评估方法在伴有休克的危重症患者人群中对代谢性酸中毒的诊断评估是否有所改善。这项前瞻性队列研究纳入了 2018 年 5 月至 2019 年 11 月期间在巴西一家三级医院 ICU 住院的休克患者。我们收集了传统评估和简化 Stewart 法所需的实验室数据。在研究期间，共有 149 例患者纳入最终分析。在 17 例 SBE 和 AG 正常的患者中，根据改良 Story 评估，有 13 例（76.5%）存在代谢性酸中毒。因此，在纳入研究的 149 例患者中，传统方法未能识别 13 例（8.7%）患者存在改良 Story 评估识别的代谢性酸中毒。此外，两种方法在代谢性酸中毒严重程度的判断上也存在差异，平均差值为-7.8 mEq/L。我们发现，改良 Story 法可以识别和量化传统方法未揭示的紊乱患者的代谢性酸中毒。
