Hypoproteinemia, strong-ion difference, and acid-base status in critically ill patients.
The present study was a prospective, nonrandomized, observational examination of the relationship among hypoproteinemia and electrolyte and acid-base status in a critical care population of patients. A total of 219 arterial blood samples reviewed from 91 patients was analyzed for arterial blood gas, electrolytes, lactate, and total protein. Plasma strong-ion difference ([SID]) was calculated from [Na+] + [K+] - [Cl-] - [La-]. Total protein concentration was used to derive the total concentration of weak acid ([A]tot). [A]tot encompassed a range of 18.7 to 9.0 meq/l, whereas [SID] varied from 48.1 to 26.6 meq/l and was directly correlated with [A]tot. The decline in [SID] was primarily attributable to an increase in [Cl-]. A direct correlation was also noted between PCO2 and [SID], but not between PCO2 and [A]tot. The decrease in [SID] and PCO2 was such that neither [H+] nor [HCO-3] changed significantly with [A]tot.
Wilkes
P
P
University of Ottawa Heart Institute, Ottawa Civic Hospital, Ontario, Canada. pwilkes@heartinst.on.ca
D000136:Acid-Base Equilibrium / Q000502:physiology*; D000328:Adult; D000368:Aged; D002245:Carbon Dioxide / Q000097:blood; D002712:Chlorides / Q000097:blood; D016638:Critical Illness / Q000453:epidemiology; D004573:Electrolytes / Q000097:blood*; D006801:Humans; D007019:Hypoproteinemia / Q000503:physiopathology*; D008875:Middle Aged; D012044:Regression Analysis; D012964:Sodium / Q000097:blood
D002712:Chlorides; D004573:Electrolytes; D002245:Carbon Dioxide; D012964:Sodium