No data of the spectrum of acid–base changes occurring in a large cohort consisting of critically ill patients is available, simply because the large number of calculations cannot be carried out manually. Most acid–base disturbances are mild and easily overseen by the clinicians but can be the first sign of a detrimental process starting. ![]() Attempts to simplify the acid–base diagnosis have been developed, but still a general method with a good clinically instant and understandable result is lacking. Often several blood gas analysis results are needed to understand dynamic processes. ![]() To do calculations manually is cumbersome and results in wrong conclusions. Acidoses were more common and more deviated compared to alkaloses.Īccurate interpretation of acid–base status is of great importance for understanding pathophysiology, making a diagnosis, planning effective treatment and monitoring progress of a critically ill patient. In our cohort, it was difficult to develop a working script based on Stewart, whereas Boston/Copenhagen worked better. ConclusionsĪcid–base theories are developed on ideal models and not on critical care patients, they require inputs that might not be available, and therefore, estimations are needed. Acidoses were less compensated compared to alkaloses. Of the disturbances 74.7% were mixed with two and 2.1% with three simultaneous disturbances. Respiratory alkalosis was the primary disturbance in 1501 (17.0%) and metabolic alkalosis in 46 (0.5%). Respiratory acidosis was the primary disturbance in 2753 (31.0%) and metabolic acidosis in 464 (5.2%). The initial blood gas analyses from 8875 admissions constituted the cohort, of which 4111 (46.3%) were normal. Results from the script correlated completely with detailed manual calculations of randomly chosen 100 blood gas results and it was able to deliver complex data on cohort level with advanced graphics. ![]() The script was compared to golden standard, calculating manually by two experienced ICU physicians. MethodsĪ simplified adaptive MATLAB script processing all available theory to date was created, evaluated and used on blood gas analyses drawn immediately after admission to ICU. We wanted to develop an automated assessment of acid–base status. Manual calculations are cumbersome, easily result in wrong conclusions. Acid–base status is important for understanding pathophysiology, making a diagnosis, planning effective treatment and monitoring progress of critically ill patients.
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