title: Severe acidosis does not predict fatal outcomes in intensive care unit patients: a retrospective analysis.
abstract: OBJECTIVE
  Severe acidosis is a potentially life-threatening acid-base imbalance. The outcome of patients with severe acidosis has only been anecdotally described. We therefore assessed the discharge rate of such patients from the intensive care unit (ICU) and survival time after the event.
  
  
  METHODS
  A retrospective evaluation of medical records of patients admitted to the ICU of Tel Aviv Medical Center between 2005 and 2010, in whom arterial blood pH less than 6.8 was documented during their ICU stay, was performed.
  
  
  RESULTS
  Twenty-eight patients were suitable for study entry. Septic shock was the most common underlying medical condition (33%). Nine (32.1%) patients were either discharged alive or survived for at least 30 days in the ICU after their arterial blood pH measurement was less than 6.8. More than a quarter of the patients with life-threatening acidosis (n = 8; 28.6%) were discharged home and returned to their prehospitalization daily activity. Mean follow-up period for these patients was 132 ± 111 weeks. Multivariate analysis identified hyperkalemia, Acute Physiology and Chronic Health Evaluation II score, and Glasgow Coma Scale as determinants for ICU death after severe acidosis.
  
  
  CONCLUSIONS
  A significant number of patients can outlast severe acidosis and return to their prehospitalization status. Larger studies are needed to define the patient population most likely to benefit from aggressive resuscitation efforts during severe acidosis.
authors.affiliation: Department of Anesthesiology, Critical Care and Pain Medicine, Tel Aviv Sourasky Medical Center, Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel; General Intensive Care Unit, Department of Anesthesiology, Critical Care and Pain Medicine, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel.
authors.forename: Yoav
authors.initials: Y
authors.lastname: Paz
authors.affiliation: Department of Anesthesiology, Critical Care and Pain Medicine, Tel Aviv Sourasky Medical Center, Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel; General Intensive Care Unit, Department of Anesthesiology, Critical Care and Pain Medicine, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel.
authors.forename: Alexander
authors.initials: A
authors.lastname: Zegerman
authors.affiliation: Department of Anesthesiology, Critical Care and Pain Medicine, Tel Aviv Sourasky Medical Center, Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel; General Intensive Care Unit, Department of Anesthesiology, Critical Care and Pain Medicine, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel.
authors.forename: Patrick
authors.initials: P
authors.lastname: Sorkine
authors.affiliation: Department of Anesthesiology, Critical Care and Pain Medicine, Tel Aviv Sourasky Medical Center, Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel; Department of Anesthesiology, Critical Care and Pain Medicine, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel. Electronic address: iditm@tlvmc.gov.il.
authors.forename: Idit
authors.initials: I
authors.lastname: Matot
mesh_terms: D000138:Acidosis / Q000401:mortality*; D000203:Activities of Daily Living; D000368:Aged; D003422:Critical Care; D005260:Female; D005500:Follow-Up Studies; D015600:Glasgow Coma Scale; D006801:Humans; D007362:Intensive Care Units; D008297:Male; D008875:Middle Aged; D010351:Patient Discharge / Q000706:statistics & numerical data*; D012189:Retrospective Studies; D012772:Shock, Septic / Q000401:mortality; D016019:Survival Analysis
keywords: Acidosis; Intensive care; Resuscitation; Sepsis; Survival