Alkalosis
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Research from Yale University, Medical Department provides new data about injury infection and critical care
2009 JUN 1 - (NewsRx.com) -- "This study assesses if a physicochemical (PC) approach to acid-base balance improves the accuracy of acid-base diagnosis, and reduces inappropriate fluid loading. Hundred consecutive patients with trauma admitted to a surgical intensive care unit at a level I trauma center were prospectively analyzed," scientists in the United States report. "Demographies, acid-base data and diagnoses, and interventions were collected. Patients were cared for by one physician using a PC approach, or four using conventional (CONV) acid-base balance techniques. The diagnoses and interventions made by CONV physicians were reviewed by the PC physician for accuracy and appropriateness using PC techniques. Data are mean +/- SD or percents; p values reflect PC evaluation of CONV analysis. There were 50 PC patients and 50 CONV. There were no differences in age (p = 0.13), injury severity score (p = 0.21), number of operations (p = 0.87), transfusions (p = 0.87), or survival (p = 0.15). CONV missed 12 diagnoses of metabolic acidosis (p = 0.03), 10 of hyperchloremic metabolic acidosis (p = 0.003), 11 metabolic alkalosis (p = 0.02), and 19 tertiary disorders (p < 0.001). CONV missed 38 diagnoses of increased unmeasured ions (p < 0.001). PC normalized their acid-base balance sooner than CONV (3.3 days +/- 3.4 days vs. 8.3 days +/- 7.4 days, p< 0.01). A PC approach imp roves acid-base diagnosis accuracy. CONV often miss acidosis (particularly those because of hyperchloremia), alkalosis, and tertiary disorders. Inappropriate volume loading follows in the wake of misinterpretation of increased base deficit using CONV and is avoided using PC," wrote L.J. Kaplan and colleagues, Yale University, Medical Department. The researchers concluded: "PC-directed therapy normalizes acid-base balance more rapidly than CONV." Kaplan and colleagues published their study in the Journal of Trauma - Injury Infection and Critical Care (A Physicochemical Approach to Acid-Base Balance in Critically III Trauma Patients Minimizes Errors and Reduces Inappropriate Plasma Volume Expansion. Journal of Trauma - Injury Infection and Critical Care, 2009;66(4):1045-1051). For more information, contact L.J. Kaplan, Yale University, School Medical, Dept. of Surgery, Sect Trauma Surgery Critical Care & Surgery Emergencies, 330 Cedar St., BB-310, New Haven, CT 06518, USA. Publisher contact information for the Journal of Trauma - Injury Infection and Critical Care is: Lippincott Williams & Wilkins, 530 Walnut St., Philadelphia, PA 19106-3621, USA. Keywords: United States, New Haven, Life Sciences, Alkalosis, Acidosis, Critical Care, Injury Infection and Critical Care, Yale University, Medical Department. This article was prepared by Anti-Infectives Week editors from staff and other reports. Copyright 2009, Anti-Infectives Week via NewsRx.com.
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