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Prognosis of patients presenting extreme acidosis (pH

Abstract：

PURPOSE:The purpose was to determine prognosis of patients presenting extreme acidosis (pH <7) on admission to the intensive care unit (ICU) and to identify mortality risk factors. MATERIALS AND METHODS:We retrospectively analyzed all patients who presented with extreme acidosis within 24 hours of admission to a polyvalent ICU in a university hospital between January 2011 and July 2013. Multivariate analysis and survival analysis were used. RESULTS:Among the 2156 patients admitted, 77 patients (3.6%) presented extreme acidosis. Thirty (39%) patients suffered cardiac arrest before admission. Although the mortality rate predicted by severity score was 93.6%, death occurred in 52 cases (67.5%) in a median delay of 13 (5-27) hours. Mortality rate depended on reason for admission, varying between 22% for cases linked to diabetes mellitus and 100% for cases of mesenteric infarction (P = .002), cardiac arrest before admission (P < .001), type of lactic acidosis (P = .007), high Simplified Acute Physiology Score II (P = .008), and low serum creatinine (P = .012). CONCLUSIONS:Patients with extreme acidosis on admission to ICU have a less severe than expected prognosis. Whereas mortality is almost 100% in cases of cardiac arrest before admission, mortality is much lower in the absence of cardiac arrest before admission, which justifies aggressive ICU therapies.

journal_name

J Crit Care

journal_title

Journal of critical care

authors

Allyn J,Vandroux D,Jabot J,Brulliard C,Galliot R,Tabatchnik X,Combe P,Martinet O,Allou N

doi

10.1016/j.jcrc.2015.09.025

subject

Has Abstract

pub_date

2016-02-01 00:00:00

pages

243-8

issue

1

eissn

0883-9441

issn

1557-8615

pii

S0883-9441(15)00506-7

journal_volume

31

pub_type

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