PDF(Pubmed)
Abstract：
CO2, HCO3, SID, and total weak acids have been defined as pH\'s independent variables. However, according to Gamble, HCO3 should be equal to the difference between the sum of cations and the sum of anions besides HCO3. Therefore, if this mathematical expression is substituted for HCO3 in the Henderson-Hasselbalch equation, all independent variables of pH can be demonstrated. Our aim is to test this theory in this study. This prospective observational study was conducted between 2019 and 2020. All admitted patients to the intensive care unit who were >18 years old were included. Demographic data, blood gas parameters, albumin, magnesium, and inorganic phosphorus levels, and outcomes were recorded twice (at admission and at the 24th hour). The multivariate linear regression model was used to determine pH\'s independent variables. In the multivariate linear regression model, pH was significantly increased by each unit increase in Na, K, Ca, and Mg (mmol L-1). In contrast, pH was significantly decreased by each unit increase in CO2, Cl, lactate, albumin (g dL-1), inorganic phosphorus (mg dL-1), and the strong ion gap. Ten independent variables can accurately predict the changes in pH. For this reason, all ten independent variables should be separately evaluated when interpreting the acid-base status. With this understanding, all algorithms regarding acid-base evaluation may become unnecessary.
摘要：
CO2、HCO3、SID、和总弱酸被定义为pH的独立变量。然而,根据Gamble的说法,HCO3应等于除HCO3之外的阳离子总和与阴离子总和之间的差。因此,如果用这个数学表达式代替Henderson-Hasselbalch方程中的HCO3，可以证明pH的所有独立变量。我们的目的是在这项研究中检验这一理论。这项前瞻性观察研究于2019年至2020年之间进行。纳入所有>18岁的重症监护病房入院患者。人口统计数据,血气参数,白蛋白,镁，和无机磷水平，结果记录两次(入院时和第24小时).采用多元线性回归模型确定pH的自变量。在多元线性回归模型中，Na每增加一个单位，pH就会显著增加，K,Ca,和Mg(mmolL-1)。相比之下,pH值随着CO2、Cl、乳酸，白蛋白（gdL-1），无机磷（mgdL-1），和强大的离子间隙。十个自变量可以准确预测pH的变化。出于这个原因,在解释酸碱状态时,应分别评估所有10个独立变量.有了这个认识,所有关于酸碱评估的算法都可能变得不必要。
