Published: 2019-01-23

Acid based disorders in intensive care unit: a hospital-based study

Babu Rajendran, Seetha Rami Reddy Mallampati, Sheju Jonathan Jha J.


Background: Acid base disorders are common in the ICU patients and pose a great burden in the management of the underlying condition.

Methods: Identifying the type of acid-base disorders in ICU patients using arterial blood gas analysis This was a retrospective case-controlled comparative study. 46 patients in intensive care unit of a reputed institution and comparing the type of acid-base disorder amongst infectious (10) and non-infectious (36) diseases.

Results: Of the study population, 70% had mixed acid base disorders and 30% had simple type of acid base disorders. It was found that sepsis is associated with mixed type of acid-base disorders with most common being metabolic acidosis with respiratory alkalosis. Non-infectious diseases were mostly associated with metabolic alkalosis with respiratory acidosis. Analysis of individual acid base disorders revealed metabolic acidosis as the most common disturbance.

Conclusions: These results projected the probability of acid bases disorders in various conditions and help in the efficient management. Mixed acid base disorders are the most common disturbances in the intensive care setup which is metabolic acidosis with respiratory alkalosis in infectious diseases and metabolic acidosis is the most common simple type of acid base disorder.


Acid base disorders, Arterial blood gas analysis, ICU metabolic disorders, Metabolic diseases

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Kellum JA. Disorders of acid-base balance. Crit Care Med. 2007;35(11):2630-6.

Al-Jaghbeer M, Kellum JA. Acid-base disturbances in intensive care patients: etiology, pathophysiology and treatment. Nephrol Dial Transplantation. 2014;30(7):1104-11.

Niwa T. Mass spectrometry in diabetes mellitus. Inter J Clin Chem. 1995;241:191.

Seifter JL. Acid-base disorders. In: Lee Goldman, Andrew I. Schafer, eds. Cecil Textbook of Medicine. 25th ed. PA: Elsevier; 2015:762-774.

Mohan A, Sharma SK. Acid base disorders. In: Munjal YP, eds. API Textbook of Medicine. 9th ed. Mumbai; Assoc-Physicians: Ind; 2012: 239-245.

Shivakumar S, Kumar DT, Ravishankar D. Acid base disorders-a study of 100 cases. Indo-US tamil doctors association conference 2006. Available at:

Conn HO, Leiberlhal MM. In: The hepatic coma syndrome and lactulose. 1st ed. Baltimore: Williams -Wilkins; 1980:106.

Kiessling SG, Goebel J, Somers MJG. Disorders of acid-base status. In: Pediatric Nephrology in ICU:Springer Berlin Heidelberg; 2008.

Bloom SA, Canzanello VJ, Strom JA, Madias NE. Spurious assessment of acid-base status due to dilutional effect of heparin. Am J Med. 1985;79(4):528-30.

Thomas DD. Acidosis and alkalosis. In: Dennis L. Kasper, Anthony S. Fauci, Stephen L. Hauser, eds. Harrison’s Principles of Internal Medicine. 19th ed. NY: McGraw-Hill; 2015: 315-324.

Grogan H, Hopkins PM. Heat stroke: implications for critical care and anaesthesia. Brit J Anaes. 2002;88(5):700-7.

Fencl V, Jabor A, Kazda A, Figge J. Diagnosis of metabolic acid-base disturbances in critically ill patients. Am J Resp Crit Care Med. 2000;162(6):2246-51.