The prevalence of acid-base disorders in patients with acute poisoning in the intensive care unit of clinical toxicology department, Isfahan, Iran

Abstract

Background: Acid-base disturbances are common in critically ill patients, and contribute to morbidity and mortality. We evaluated the prevalence of acid-base disturbances in cases with acute poisoning admitted to intensive care unit (ICU). Methods: In this cross-sectional study, patients with acute poisoning hospitalized in ICU of a university hospital affiliated with Isfahan University of Medical Sciences, Isfahan, Iran, from March 2016 to December 2017 were included. The acid-base status of the patients on admission time in emergency room, and its association with demographic factors, as well as clinical manifestations and outcome was recorded. Outcome was defined as survived without complication and complication/death. Findings: The majority of patients had acid-base disorder (89.7). Most patients had metabolic acidosis (31.3) on admission time, and most of them were men (71.6) (P = 0.01). 48 patients (22.4) were alert, of whom, 93.8 had an acid-base disorder. 60 patients (28.03) were admitted with stupor and coma, of whom, 89.1 had acid-base disorder. There was a significant relationship between acid-base state with gender and level of consciousness at the time of admission (P < 0.05). There was also a significant correlation between treatment outcome with age, toxic agents, and abnormal electrocardiography (ECG). Among different evaluated variables, age was the determinant factor in outcome prediction (P = 0.01; odds ratio (OR) = 1.02; 95 confidence interval (CI) = 1.004-1.04). Conclusion: Acid-base disorders are common in patients with acute poisoning. The level of consciousness on admission and gender are important associated factors. The status of acid-base on the admission is not the only factor affecting outcomes and prognosis, and should be assessed along with other factors. © 2019, Isfahan University of Medical Sciences(IUMS). All rights reserved.