{"title":"Base excess and pH as predictors of outcomes in secondary peritonitis in a resource limited setting - A prospective study","authors":"O. Afuwape, O. Ayandipo, Samuel Aroso","doi":"10.4103/jcls.jcls_18_20","DOIUrl":null,"url":null,"abstract":"Background: Estimation of the serum pH and base excess as determinants of the adequacy of resuscitation may predict the patient outcome in peritonitis. Materials, Patients and Methods: This was a prospective study conducted in University College Hospital, Ibadan, on patients from 18 years and above with diagnosis of secondary peritonitis who had exploratory laparotomy over a 4-month period (January to April 2017). The patients' biodata, pulse rate, blood pressure, and clinical diagnosis were documented. At presentation, the patients were resuscitated with intravenous normal saline and broad-spectrum antibiotics. Each patient had measurements of acid-base status, and pH analyzed at presentation and in the immediate postoperative period (within 1 h) using the I-STAT point of care device. They were followed up for 48 h after the surgery. The changes in base excess and serum pH in survivors and nonsurvivors were described at 48 h after surgery. This was statistically compared using SPSS version 20 (Chicago, IL, USA). Results: A total of 45 patients were recruited comprising 37 males and 8 female patients. The mean age was 40.86 ± 15.45 years. The mean admission base excess was −4.76 ± 5.41. The mean admission pH was 7.41 ± 0.07. There were 28 (62%) survivors and 17 (38%) mortalities. The pH on admission and base excess values and after surgery demonstrated statistical significance in survivors and nonsurvivors. Conclusion: Changes in base excess and serum pH values are plausible outcome markers in patients with peritonitis resuscitated with early goal-directed therapy.","PeriodicalId":15490,"journal":{"name":"Journal of Clinical Sciences","volume":null,"pages":null},"PeriodicalIF":0.2000,"publicationDate":"2020-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"3","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Journal of Clinical Sciences","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.4103/jcls.jcls_18_20","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q4","JCRName":"MEDICINE, GENERAL & INTERNAL","Score":null,"Total":0}
引用次数: 3
Abstract
Background: Estimation of the serum pH and base excess as determinants of the adequacy of resuscitation may predict the patient outcome in peritonitis. Materials, Patients and Methods: This was a prospective study conducted in University College Hospital, Ibadan, on patients from 18 years and above with diagnosis of secondary peritonitis who had exploratory laparotomy over a 4-month period (January to April 2017). The patients' biodata, pulse rate, blood pressure, and clinical diagnosis were documented. At presentation, the patients were resuscitated with intravenous normal saline and broad-spectrum antibiotics. Each patient had measurements of acid-base status, and pH analyzed at presentation and in the immediate postoperative period (within 1 h) using the I-STAT point of care device. They were followed up for 48 h after the surgery. The changes in base excess and serum pH in survivors and nonsurvivors were described at 48 h after surgery. This was statistically compared using SPSS version 20 (Chicago, IL, USA). Results: A total of 45 patients were recruited comprising 37 males and 8 female patients. The mean age was 40.86 ± 15.45 years. The mean admission base excess was −4.76 ± 5.41. The mean admission pH was 7.41 ± 0.07. There were 28 (62%) survivors and 17 (38%) mortalities. The pH on admission and base excess values and after surgery demonstrated statistical significance in survivors and nonsurvivors. Conclusion: Changes in base excess and serum pH values are plausible outcome markers in patients with peritonitis resuscitated with early goal-directed therapy.
背景:估计血清pH值和碱性过剩作为复苏充分性的决定因素,可以预测腹膜炎患者的预后。材料、患者和方法:这是一项在伊巴丹大学学院医院进行的前瞻性研究,研究对象为18岁及以上诊断为继发性腹膜炎的患者,他们在4个月的时间内(2017年1月至4月)进行了剖腹探查。记录患者的生物资料、脉搏率、血压和临床诊断。入院时,给予静脉生理盐水和广谱抗生素复苏。使用I-STAT护理点装置测量每位患者在就诊时和术后1小时内的酸碱状态和pH值。术后随访48小时。在手术后48小时描述幸存者和非幸存者的碱基过量和血清pH的变化。使用SPSS version 20 (Chicago, IL, USA)进行统计比较。结果:共纳入45例患者,其中男37例,女8例。平均年龄40.86±15.45岁。平均入院基准超额为- 4.76±5.41。平均入院pH为7.41±0.07。幸存者28例(62%),死亡17例(38%)。入院时和手术后的pH值在幸存者和非幸存者中具有统计学意义。结论:碱过量和血清pH值的变化可能是腹膜炎患者早期目标导向治疗复苏的预后指标。