Etiologies and Outcomes of various types of Acid-Base Disorders in Respiratory intensive care unit

Abstract

Objective: Acid-base disorders (ABDs) are usually correlated with high rates of morbidity and mortality. The objective of this study was to analyze the causes, outcomes, and types of ABDs in patients presenting at the Respiratory intensive care unit (RICU). Material and Methods: We prospectively analyzed data from 80 patients who presented between july2012 and august 2014. Data on age, gender, chief complaint, diagnosis and outcomes in the RICU were collected for ABD cases. Results: Of the 80 cases with an ABD, 32 patients (40%) had simple ABD and 48 patients (60%) had mixed ABD. The most common ABD was a mixed respiratory acidosis and metabolic alkalosis (RACMAL) (n=28, 35%). All ABD types were most commonly observed in patients over 60 years of age. In cases of ABD, COPD was the most common diagnosis (30%). Of the ABD cases, 44 patients (55%) were treated and discharged without needing ventilator support (invasive or noninvasive). 20 patients (25%) improved with NIV (non invasive ventilation), 7 patients (8.75%) recovered after receiving IV (invasive ventilation) while 9 patients (11.25%) died even with IV. Death was more commonly observed in cases with mixed metabolic and respiratory acidosis (MACRAC) (n=4). The most common etiology among intubated and survived cases is COPD (chronic obstructive pulmonary diseases) (n=5, 71.42%), and among intubated and expired cases is ARDS (acute respiratory distress syndrome)/ sepsis (n=7, 77.78%) Conclusion: ABDs are quite common in patients presenting at the RICU, especially among patients in a critical condition (71%). Mixed RACMAL was the most commonly noted ABD. COPD was the most common diagnoses in ABD patients followed by pneumonia and ARDS. Mortality was more common in cases with a mixed MACRAC. High mortality was seen in the ARDS/sepsis cases. This knowledge may provide important information concerning the diagnosis, treatment and early prognosis of patients.