Dados do Trabalho

Título

Acid-base status of critically ill COVID-19 patients by Stewart's methodology: a cohort study

Objetivo

Describe the acid-base disorders of critically ill COVID-19 patients using Stewart's approach, associating its variables with outcomes such as mortality and renal dialysis.

Métodos

This is a retrospective cohort of adult patients with an ICU stay of more than 4 days, with blood gas analysis and a typical chest CT involvement at admission. A SARS-COV-2 infection was diagnosed by a positive PCR from a nasal swab.

Resultados

211 patients were analyzed, and their mortality rate was 13.7%. Overall, 149 patients (70.6%) presented with alkalosis, 28 had acidosis (13.3%), and the remaining 34 patients (16.2%) had a normal arterial pH. Blood gas variables were similar in both surviving and non-surviving patients; overall, we did not find severe acid-base derangement in this population. Stewart‘s variables analyzed—SID eff, SID app, SIG, and the albumin, lactate, phosphorus, and chloride effects—were not different between surviving and non-surviving patients.

Conclusão

Alkalemia was the most prevalent acid-base disturbance in this population, and it was mainly of respiratory origin. Although we did not find an association between acid-base variables by Stewart's methodology and mortality, dialysis, or respiratory failure, the use of this innovative methodology may provide valuable insights into the description of this severe disease.