Analysis of acid–base disorders in an ICU cohort using a computer script
Forsal, Innas LU ; Bodelsson, Mikael LU ; Wieslander, Anders ; Nilsson, Anders LU ; Pouchoulin, Dominique and Broman, Marcus LU
(2022)
In Intensive Care Medicine Experimental
10(1).
- Abstract
Background/aims: Acid–base status is important for understanding pathophysiology, making a diagnosis, planning effective treatment and monitoring progress of critically ill patients. Manual calculations are cumbersome, easily result in wrong conclusions. We wanted to develop an automated assessment of acid–base status. Methods: A simplified adaptive MATLAB script processing all available theory to date was created, evaluated and used on blood gas analyses drawn immediately after admission to ICU. The script was compared to golden standard, calculating manually by two experienced ICU physicians. Results: Results from the script correlated completely with detailed manual calculations of randomly chosen 100 blood gas results and it was... (More)
Background/aims: Acid–base status is important for understanding pathophysiology, making a diagnosis, planning effective treatment and monitoring progress of critically ill patients. Manual calculations are cumbersome, easily result in wrong conclusions. We wanted to develop an automated assessment of acid–base status. Methods: A simplified adaptive MATLAB script processing all available theory to date was created, evaluated and used on blood gas analyses drawn immediately after admission to ICU. The script was compared to golden standard, calculating manually by two experienced ICU physicians. Results: Results from the script correlated completely with detailed manual calculations of randomly chosen 100 blood gas results and it was able to deliver complex data on cohort level with advanced graphics. The initial blood gas analyses from 8875 admissions constituted the cohort, of which 4111 (46.3%) were normal. Respiratory acidosis was the primary disturbance in 2753 (31.0%) and metabolic acidosis in 464 (5.2%). Respiratory alkalosis was the primary disturbance in 1501 (17.0%) and metabolic alkalosis in 46 (0.5%). Of the disturbances 74.7% were mixed with two and 2.1% with three simultaneous disturbances. Acidoses were less compensated compared to alkaloses. Conclusions: Acid–base theories are developed on ideal models and not on critical care patients, they require inputs that might not be available, and therefore, estimations are needed. In our cohort, it was difficult to develop a working script based on Stewart, whereas Boston/Copenhagen worked better. Acidoses were more common and more deviated compared to alkaloses.
(Less)
- author
- Forsal, Innas
LU
; Bodelsson, Mikael
LU
; Wieslander, Anders
; Nilsson, Anders
LU
; Pouchoulin, Dominique
and Broman, Marcus
LU
- publishing date
- 2022-12
- type
- Contribution to journal
- publication status
- published
- subject
- keywords
- Acidosis, Acid–base disturbance, Acute kidney injury, Alkalosis, Critical care, Homeostasis
- in
- Intensive Care Medicine Experimental
- volume
- 10
- issue
- 1
- article number
- 11
- publisher
- Springer Nature
- external identifiers
-
- scopus:85127564726
- ISSN
- 2197-425X
- DOI
- 10.1186/s40635-022-00437-8
- language
- English
- LU publication?
- no
- additional info
- Publisher Copyright: © 2022, The Author(s).
- id
- bc64f641-89d7-4f81-b363-31765ab13dc4
- date added to LUP
- 2026-07-02 12:30:25
- date last changed
- 2026-07-02 12:30:36
@article{bc64f641-89d7-4f81-b363-31765ab13dc4,
abstract = {{<p>Background/aims: Acid–base status is important for understanding pathophysiology, making a diagnosis, planning effective treatment and monitoring progress of critically ill patients. Manual calculations are cumbersome, easily result in wrong conclusions. We wanted to develop an automated assessment of acid–base status. Methods: A simplified adaptive MATLAB script processing all available theory to date was created, evaluated and used on blood gas analyses drawn immediately after admission to ICU. The script was compared to golden standard, calculating manually by two experienced ICU physicians. Results: Results from the script correlated completely with detailed manual calculations of randomly chosen 100 blood gas results and it was able to deliver complex data on cohort level with advanced graphics. The initial blood gas analyses from 8875 admissions constituted the cohort, of which 4111 (46.3%) were normal. Respiratory acidosis was the primary disturbance in 2753 (31.0%) and metabolic acidosis in 464 (5.2%). Respiratory alkalosis was the primary disturbance in 1501 (17.0%) and metabolic alkalosis in 46 (0.5%). Of the disturbances 74.7% were mixed with two and 2.1% with three simultaneous disturbances. Acidoses were less compensated compared to alkaloses. Conclusions: Acid–base theories are developed on ideal models and not on critical care patients, they require inputs that might not be available, and therefore, estimations are needed. In our cohort, it was difficult to develop a working script based on Stewart, whereas Boston/Copenhagen worked better. Acidoses were more common and more deviated compared to alkaloses.</p>}},
author = {{Forsal, Innas and Bodelsson, Mikael and Wieslander, Anders and Nilsson, Anders and Pouchoulin, Dominique and Broman, Marcus}},
issn = {{2197-425X}},
keywords = {{Acidosis; Acid–base disturbance; Acute kidney injury; Alkalosis; Critical care; Homeostasis}},
language = {{eng}},
number = {{1}},
publisher = {{Springer Nature}},
series = {{Intensive Care Medicine Experimental}},
title = {{Analysis of acid–base disorders in an ICU cohort using a computer script}},
url = {{http://dx.doi.org/10.1186/s40635-022-00437-8}},
doi = {{10.1186/s40635-022-00437-8}},
volume = {{10}},
year = {{2022}},
}