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학술연구/단체지원/교육 등 연구자 활동을 지속하도록 DBpia가 지원하고 있어요.
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연구자들이 자신의 연구와 전문성을 널리 알리고, 새로운 협력의 기회를 만들 수 있는 네트워킹 공간이에요.
논문 기본 정보
- 자료유형
- 학술저널
- 저자정보
- 발행연도
- 2021.12
- 수록면
- 72 - 82 (11page)
- DOI
- 10.22537/jksct.2021.19.2.72
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초록· 키워드
오류제보하기
Purpose: A high anion gap (AG) is known to be a significant risk factor for serious acid-base imbalances and death in acute poisoning cases. The strong ion difference (SID), or strong ion gap (SIG), has recently been used to predict in-hospital mortality or acute kidney injury (AKI) in patients with systemic inflammatory response syndrome. This study presents a comprehensive acidbase analysis in order to identify the predictive value of the SIG for disease severity in severe poisoning.
Methods: A cross-sectional observational study was conducted on acute poisoning patients treated in the emergency intensive care unit (ICU) between December 2015 and November 2020. Initial serum electrolytes, base deficit (BD), AG, SIG, and laboratory parameters were concurrently measured upon hospital arrival and were subsequently used along with Stewart’s approach to acid-base analysis to predict AKI development and in-hospital death. The area under the receiver operating characteristic curve (AUC) and logistic regression analysis were used as statistical tests.
Results: Overall, 343 patients who were treated in the intensive care unit were enrolled. The initial levels of lactate, AG, and BD were significantly higher in the AKI group (n=62). Both effective SID [SIDe] (20.3 vs. 26.4 mEq/L, p<0.001) and SIG (20.2 vs. 16.5 mEq/L, p<0.001) were significantly higher in the AKI group; however, the AUC of serum SIDe was 0.842 (95% confidence interval [CI]=0.799-0.879). Serum SIDe had a higher predictive capacity for AKI than initial creatinine (AUC=0.796, 95% CI=0.749-0.837), BD (AUC=0.761, 95% CI=0.712-0.805), and AG (AUC=0.660, 95% CI=0.607-0.711). Multivariate logistic regression analyses revealed that diabetes, lactic acidosis, high SIG, and low SIDe were significant risk factors for in-hospital mortality.
Conclusion: Initial SIDe and SIG were identified as useful predictors of AKI and in-hospital mortality in intoxicated patients who were critically ill. Further research is necessary to evaluate the physiological nature of the toxicant or unmeasured anions in such patients.
목차
등록된 정보가 없습니다.
참고문헌 (24)
참고문헌 신청
Cusack RJ / 2002 / The strong ion gap does not have prognostic value in critically ill patients in a mixed medical/surgical adult ICU / Intensive Care Med 28:864~869
Shen X / 2016 / The prognostic value of the strong ion gap in acute pancreatitis / J Crit Care 36:140~145
Berndtson AE / 2013 / Strong ion difference and gap predict outcomes after adult burn injury / J Trauma Acute Care Surg 75:555~560
Zehtabchi S / 2007 / Utility of Stewart’s strong ion difference as a predictor of major injury after trauma in the ED / Am J Emerg Med 25:938~941
Ho KM / 2016 / A comparison of prognostic significance of strong ion gap(SIG)with other acid-base markers in the critically ill : a cohort study / J Intensive Care 4:43
Shen X / 2016 / The prognostic value of the strong ion gap in acute pancreatitis / J Crit Care 36:140~145
Berndtson AE / 2013 / Strong ion difference and gap predict outcomes after adult burn injury / J Trauma Acute Care Surg 75:555~560
Zehtabchi S / 2007 / Utility of Stewart’s strong ion difference as a predictor of major injury after trauma in the ED / Am J Emerg Med 25:938~941
Ho KM / 2016 / A comparison of prognostic significance of strong ion gap(SIG)with other acid-base markers in the critically ill : a cohort study / J Intensive Care 4:43
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