title: Predictive value of serum bicarbonate, arterial base deficit/excess and SAPS III score in critically ill patients.
abstract: Arterial base deficit/excess (BD/E) is commonly used marker of metabolic acidosis in critically ill patients, but requires an arterial puncture and blood gas analysis. We hypothesized that serum bicarbonate (HCO3), which can be routinely obtained, strongly correlates with arterial BD/E and provides equivalent predictive information. In addition, we evaluated predictive value of simplified acute physiology score III (SAPS III). Total of 152 critically ill surgical patients were included in retrospective analysis. On admission to intensive care unit sets of simultaneously obtained paired laboratory data, including an arterial blood gas and serum chemistry panel with serum HCO3 were obtained. Very strong correlation between BD/E and simultaneously measured serum HCO3 levels was found (r = 0.857, R(2) = 0.732, p < 0.01). The serum HCO3 level reliably identified a significant metabolic acidosis (AUC = 0.761, p < 0.05). BD and SAPS III were good predictors of mortality (AUCs 0.70 and 0.74, respectively). Serum HCO3 may be used as substitute to detect severe metabolic acidosis. BD and SAPS III score were good predictors of mortality.
authors.affiliation: Clinic of Anesthesiology and Intensive Therapy, Military Medical Academy, Crnotravska 17, Belgrade 11000, Serbia. MAYA@EUnet.rs
authors.forename: Maja
authors.initials: M
authors.lastname: Surbatovic
authors.forename: Sonja
authors.initials: S
authors.lastname: Radakovic
authors.forename: Miodrag
authors.initials: M
authors.lastname: Jevtic
authors.forename: Nikola
authors.initials: N
authors.lastname: Filipovic
authors.forename: Predrag
authors.initials: P
authors.lastname: Romic
authors.forename: Nada
authors.initials: N
authors.lastname: Popovic
authors.forename: Jasna
authors.initials: J
authors.lastname: Jevdjic
authors.forename: Krasimirka
authors.initials: K
authors.lastname: Grujic
authors.forename: Dragan
authors.initials: D
authors.lastname: Djordjevic
mesh_terms: D018806:APACHE; D001158:Arteries / Q000737:chemistry*; D001639:Bicarbonates / Q000097:blood*; D016638:Critical Illness; D005260:Female; D006801:Humans; D006863:Hydrogen-Ion Concentration; D008297:Male; D008875:Middle Aged; D009102:Multiple Organ Failure / Q000150:complications / Q000473:pathology; D011237:Predictive Value of Tests; D011379:Prognosis; D012372:ROC Curve; D012189:Retrospective Studies; D018805:Sepsis / Q000150:complications
chemical_list: D001639:Bicarbonates