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Identifier |
000393376 |
Title |
Η φυσικοχημική προσέγγιση των οξεοβασικών διαταραχών |
Alternative Title |
The physicochemical approach of acid base disturbances |
Author
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Αντωνογιαννάκη, Ελβίρα-Μαρκέλα
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Thesis advisor
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Γεωργόπουλος, Δημήτριος
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Reviewer
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Κονδύλη, Ευμορφία
De Bree, Eelco
Αγγουριδάκης, Παναγιώτης
Τζανάκης, Νικόλαος
Αντωνίου, Αικατερίνη
Γκίκας, Αχιλλέας
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Abstract |
Aim: The aim of this thesis is to evaluate the value of physicochemical, base excess (BE) and plasma bicarbonate concentration ([HCO3-]) approaches on the assessment of acid-base status in patients presented to the Emergency Department (ED). Methods: Upon presentation at ED, patients whose arterial blood was deemed in need of analysis were studied. Arterial blood gases, serum electrolytes and proteins were measured and used to derive [HCO3-], BE, anion gap (AG), AG adjusted for albumin (AGadj), strong ion difference, strong ion gap (SIG) and SIG corrected for water excess/deficit (SIGcor). Results: A total of 365 patients were studied. Compared to BE (n=202) and [HCO3-] (n=151), physicochemical approach (n=279) identified significantly more patients with metabolic acid-base disturbances (p<0.0001). Significantly fewer patients with unmeasured anions acidosis were identified with AGadj than with SIGcor (p<0.0001). On the basis of BE, 75 patients had normal acid base balance and 65(87%) of them exhibited at least one hidden acid-base disturbance, identified by the physicochemical approach. The corresponding values with [HCO3-] approach were 108 and 95(88%) patients. When patients with high AGadj were excluded, 44 patients with BE and 67 with [HCO3-] approach had normal acid-base status, and the majority of them exhibited at least one acid-base disturbance with the physicochemical approach, while 12 and 21 patients, respectively, had high SIGcor. Mortality was 10.7% and logistic regression analysis identified only Sepsis–related Organ Failure Assessment and SIGcor as predictors of mortality. Conclusion: In patients presented to ED, compared to BE and [HCO3-] methods, physicochemical approach has a better diagnostic accuracy to identify metabolic acid-base disturbances and may predict mortality.
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Physical description |
πίν. ; 30 εκ. |
Language |
Greek |
Subject |
Base excess |
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Bicardonate |
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Emergency department |
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Emergency department |
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Διττανθρακικά |
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Ελλειμα βάσης |
Issue date |
2015-07-17 |
Collection
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School/Department--School of Medicine--Department of Medicine--Doctoral theses
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Type of Work--Doctoral theses
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Permanent Link |
https://elocus.lib.uoc.gr//dlib/f/8/7/metadata-dlib-1432114889-794931-30365.tkl
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Views |
345 |