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PubMed1999

[Effection of children airway foreign bodies on blood acid-base disturbances].

OBJECTIVE: To explore the effects of children airway foreign bodies on blood acid-base disturbances. METHOD: To detect the blood-gas and electrolyte of 50 cases by children airway foreign bodies (test group), they were compared with 50 cases normal children (control group). To calculate anion gap (AG), to determine types of acidbase disturbances. RESULT: The blood-gas and K+ were significant difference between that two groups. In the test group, there were 25 simple and 19 mixed acid-base disturbances; 6 acid-base balances. There were 31 high AG, 18 normal AG, one low AG. CONCLUSION: Children airway foreign bodies can cause acid-base disturbances. It was major in simple metabolic acidosis and mixed metabolic acidosis with respiratory alkalosis, it was more in high AG-metabobic acidosis.

Acid-Base Imbalance↗
PubMed2004

Uncompensated metabolic acidosis: an underrecognized risk factor for subsequent intubation requirement.

BACKGROUND: There are no published reports identifying an inadequate ventilatory response to metabolic acidosis as a predictor of impending respiratory failure. Metabolic acidosis should induce a respiratory alkalosis in which the partial pressure of carbon dioxide (Paco2) is (1.5 [HCO3-] + 8) +/- 2. This study examined the relation between inadequate ventilatory compensation and intubation among trauma patients. METHODS: A retrospective chart review was performed for trauma patients admitted between January 1999 and December 2000. Age, gender, Injury Severity Score and combined Trauma and Injury Severity Score, chest injury, history of cardiac or pulmonary disease, partial pressure of oxygen (Pao2), Paco2, Glasgow Coma Score, respiratory rate, systolic blood pressure, base deficit, and ability to compensate were analyzed with respect to intubation and need for ventilator support. RESULTS: Of 140 patients with metabolic acidosis, 45 ultimately were intubated. The mean Paco2 for the unintubated patients was 34 +/- 7 mm Hg, as compared with 41 +/- 11 mm Hg for the intubated patients (p < 0.001). Only injury severity and ability to compensate for metabolic acidosis were independent predictors of intubation. Patients with inadequate compensation were 4.2 times more likely to require intubation when control was used for the Injury Severity Score (95% confidence interval, 1.8-9.7; p < 0.001). CONCLUSIONS: Inability to mount an adequate hyperventilatory response to metabolic acidosis is associated with an increased likelihood of respiratory failure and a need for ventilatory support. Recognition of this relation should lead to closer monitoring of patients with this condition, and could help to avert unforeseen crisis intubations. This observation needs to be validated in a prospective study.

Acidosis↗