Metabolic acidosis in patients with severe sepsis and septic shock: A longitudinal quantitative study

• DOI: 10.1097/ccm.0b013e3181a59165
• Publication Date: 2009-09-18T11:46:37Z
• Authors: Danilo T. Noritomi; Francisco G. Soriano; John A. Kellum; Sylas B. Cappi; Paolo J. C. Biselli; Alexandre B. Libório; Marcelo Park
• Keywords: Anion gap; Hyperchloremia; Base excess

To describe the composition of metabolic acidosis in patients with severe sepsis and septic shock at intensive care unit admission throughout first 5 days stay.Prospective, observational study.Twelve-bed unit.Sixty either or shock.None.Data were collected until after admission. We studied contribution inorganic ion difference, lactate, albumin, phosphate, strong gap to acidosis. At admission, standard base excess was -6.69 +/- 4.19 mEq/L survivors vs. -11.63 4.87 nonsurvivors (p < .05); difference (mainly resulting from hyperchloremia) responsible for a decrease by 5.64 4.96 8.94 7.06 4.07 3.57 4.92 5.55 nonsignificant probability value; lactate 1.34 2.07 1.61 2.25 value. Albumin had an important alkalinizing effect both groups; phosphate minimal acid-base effect. Acidosis corrected during study period as result levels, whereas did not correct their In addition Acute Physiology Chronic Health Evaluation II score serum creatinine level,inorganic magnitude independently associated worse outcome.Patients exhibit complex caused predominantly hyperchloremic acidosis,which more pronounced nonsurvivors. resolution attributable levels.