Acid-base disturbances in acute poisoning and their association with survival

作者：Hamdi Haleh; Hassanian Moghaddam Hossein^*; Hamdi Amir; Zahed Narges Sadat

来源：Journal of Critical Care, 2016, 35: 84-89.

DOI：10.1016/j.jcrc.2016.05.003

• Critical care
• Drug abuse
• Drugs
• Emergency medicine
• Care management
• Severity of illness

Purpose: The purpose was to investigate the association between acid-base disturbances and mortality in acute poisoning.
Materials and methods: We performed a retrospective cross-sectional exploratory study on all acutely poisoned patients older than 12 years who had been admitted to the main tertiary toxicology hospital in Tehran between March and August 2010.
Results: Of a total of 1167 patients (median age= 25 years, 50.9% male), 98 died (74.5% male). Psychotropic medications were the most common cause of poisoning (36.5%), whereas narcotics and psychodysleptics were the most common cause of death (23.5%). Mixed respiratory alkalosis and metabolic acidosis with normal pH were the most common acid-base status (333, 28.5%). However, patients with primary metabolic acidosis and respiratory compensation had significantly higher mortality (31 cases, 18.8%). Logistic regression analysis identified age (odds ratio [OR], 1.051; 95% confidence interval [CI], 1.031-1.070; P < .001), intensive care unit admission (OR, 12.405; 95% CI, 7.178-21.440; P < .001), consciousness level (OR, 1.752; 95% CI, 1.301-2.359; P < .001), hospitalization period (OR, 1.1361; 95% CI, 1.079-1.195; P < .001), severe metabolic acidosis (OR, 6.016; 95% CI, 1.647-21.968; P =.007), and primary respiratory alkalosis (OR, 5.579; 95% CI, 1.353-23.001; P = .017) as death predictors during hospitalization (P < .001).
Conclusion: On-arrival acid-base status predicts survival and can be used in prognostication of the poisoned patients.

• 出版日期2016-10