Vol. 4, Issue 1 (2019)
Study of acid-base imbalance in critically ill patients and its outcome in emergency medical ward of Hamidia Hospital: A study from Bhopal
Author(s): Dr. JL Wadhwani, Dr. K Deopujari, Dr. RS Jagat, Dr. Praveen Shukla
Abstract: Background: In the intensive care unit acid-base imbalance is a frequently observed event among the critically ill patients (CIP). There is limited evidence describing the acid-base imbalance in different diseases and its relation with the anion gap. Aims and Objectives: To study the incidence, type of acid-base imbalance, its prognosis, and association with the different conditions in CIP admitted in the emergency ward. Materials and Methods: Hundred CIP were studied in the Department of Medicine Gandhi Medical College, Hamidia Hospital in Emergency Ward-II from October 2011 to November 2012. Detailed demographic profile including details of complications, comorbid conditions, duration of stay in emergency ward, outcome of patients (recovery after treatment), correlation with death of patients, vital parameters at the time of admission, relation between type of disease and acid-base imbalance and relation between mortality and type of acid-base imbalance was recorded. Results: Maximum number of patients were in the age group of 15-30 years (n=35). Majority of the CIP who did not survive had liver disease (80%), respiratory disease (54.54%) and cerebral (neurological disease) (50%). Most common acid-base disorder among patients who did not survive was metabolic acidosis, respiratory alkalosis. Percentage fatality was highest among the patients who had mixed acidemia (50%) and mixed alkalosis (50%), respiratory alkalosis (36.8%) and Metabolic Acidosis (34.3%). The pH, PCO2 and PO2 were significantly high among the CIP with anion gap <11 as compared to those with anion gap>11. Conclusion: Acid-base disorders are very common in CIP mainly metabolic acidosis. Considering the anion gap increase the prevalence of acid-base disorders. Unmeasured anion, lactate etc. play important role in mortality and morbidity of patients.