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Volume 24, Issue 4, Pages 484-491 (December 2009)


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Effect of Paco2 variation on standard base excess value in critically ill patients

Marcelo Park, MDCorresponding Author Informationemail address, Alexandre Toledo Maciel, MD, Danilo Teixeira Noritomi, MD, Luciano Cesar Pontes de Azevedo, MD, Leandro Utino Taniguchi, MD, Luiz Monteiro da Cruz Neto, MD

published online 11 May 2009.

Abstract 

Purpose

The aim of this study was to investigate the impact of acute Paco2 temporal variation on the standard base excess (SBE) value in critically ill patients.

Methods

A total of 265 patients were prospectively observed; 158 were allocated to the modeling group, and 107 were allocated to the validation group. Two models were developed in the modeling group (one including and one excluding Paco2 as a variable determinant of SBE), and both were tested in the validation group.

Results

In the modeling group, the mathematical model including SIDai, SIG, l-lactate, albumin, phosphate, and Paco2 had a predictive superiority in comparison with the model without Paco2 (R2 = 0.978 and 0.916, respectively). In the validation group, the results were confirmed with significant F change statistics (R2 change = 0.059, P < .001) between the model with and without Paco2. A high correlation (R = 0.99, P < .001) and agreement (bias = −0.25 mEq/L, limits of agreement 95% = −0.72 to 0.22 mEq/L) were found between the model-predicted SBE value and the SBE calculated using the Van Slyke equation.

Conclusions

Acute Paco2 temporal variation is related to SBE changes in critically ill patients.

Emergency Department, Intensive Care Unit, Hospital das Clínicas, University of São Paulo Medical School, São Paulo 0563010, Brazil

Corresponding Author InformationCorresponding author.

PII: S0883-9441(09)00055-0

doi:10.1016/j.jcrc.2008.12.018


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