The Relationship of Acidosis and Coagulopathy in Patients Admitted to Intensive Care Units

Document Type : Original Article (s)

Authors

1 Professor, Anesthesiology and Critical Care Research Center, Isfahan University of Medical Sciences, Isfahan, Iran

2 Associate Professor, Anesthesiology and Critical Care Research Center, Isfahan University of Medical Sciences, Isfahan, Iran

3 Resident, Department of Anesthesiology, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran

Abstract

Background: One of the markers of coagulopathy incidence in critical patients is acidosis that leads to increasing mortality and morbidity rates in patients hospitalized in intensive care unit (ICU). The aim of this study was determining the relationship between acidosis and coagulopathy in patients admitted to the intensive care units.Methods: In a cross-sectional study done in intensive care units of therapeutic and educative centers in Isfahan city, Iran, 120 critical patients were enrolled. The criteria of acidosis and coagulopathy were examined during 14 days and the relationship between intensity of that was determined.Findings: Of 120 patients, 15 suffered from severe acidosis; 2 of them (13.3%) had moderate and 13 (86.8%) had severe coagulopathy. 20 patients suffered from moderate acidosis that 9 (45.0%) had mild and 9 (45.0%) had moderate coagulopathy. 23 patients suffered from mild acidosis that 16 (69.6%) had mild, 2 (8.7%) had moderate, and 5 (21.7%) had sever coagulopathy. In addition, of 62 of patients without acidosis, 38 (61.3%) had mild and 8 (12.9%) had moderate coagulopathy. There was a significant relationship between the intensity of acidosis and the intensity of coagulopathy (P < 0.001).Conclusion: The intensity of acidosis and the intensity of coagulopathy had significant relationship. Total factors of acidosis and coagulopathy had a positive role in patients' outcomes. So, in patients with acidosis, specially sever intensity, total activity must be done to prevent coagulopathy.

Keywords

References

  1. Goldman L, Schafer AI. Goldman's cecil medicine. 24th ed. Philadelphia, PA: Saunders; 2011. p. 503.
  2. Marino PL, Sutin KM. Acid-base interpretations. In: Marino PL. The ICU Book. 3rd ed. Philadelphia, PA: Lippincott Williams and Wilkins; 2006. p. 558-74.
  3. Slaughter T. Coagulation. In: Miller RD, Eriksson LI, Fleisher LA, Wiener-Kronish JP, Cohen NH, Young WL, editors. Miller's anesthesia. 8th ed. Philadelphia, PA: Saunders; 2014. p. 1868-80.
  4. Rinder CS. Hematologic disorders. In: Hines RL, Marschall K, editors. Stoelting's anesthesia and co-existing diseases. 6th ed. Philadelphia, PA: Saunders; 2012. p. 489-505.
  5. Liu LL. Acid-base balance and blood gas analysis. In: Miller RD, Pardo MC, editors. Basics of anesthesia. 6th ed. Philadelphia, PA: Saunders; 2011. p. 334-47.
  6. Aird WC. Coagulopathy. In: Vincent JL, Abraham E, Kochanek P, Moore F, Fink M, editors. Textbook of Critical Care. 6th ed. Philadelphia, PA: Saunders; 2011. p. 82-3.
  7. Neligan PJ, Deutschman CS. Perioperative. acid-base. balance. In: Miller RD, Eriksson LI, Fleisher LA, Wiener-Kronish JP, Cohen NH, Young WL, editors. Miller's anesthesia. 8th ed. Philadelphia, PA: Saunders; 2014. p. 1811-29.
  8. Stoelring RD, Dierdorf SF. Fluid, electrolyte and acid-base disorders. In: Hines RL, Marschall K, editors. Stoelting's anesthesia and co-existing diseases. 6th ed. Philadelphia, PA: Saunders; 2012. p. 373-95.
  9. Kellum JA. Acid-base disorders [Online]. [cited 2015 Mar 22]; Available from: URL: http://clinicalgate.com/acid-base-disorders-2/
  10. Cheddie S, Muckart DJ, Hardcastle TC. Base deficit as an early marker of coagulopathy in trauma. S Afr J Surg 2013; 51(3): 88-90.
  11. Martini WZ. Coagulopathy by hypothermia and acidosis: mechanisms of thrombin generation and fibrinogen availability. J Trauma 2009; 67(1): 202-8.
  12. Balekouzou A, Pamatika CM, Nambei SW, Djeintote M, Mossoro D, Ditu K, et al. Management of biomedical waste in two medical laboratories in Bangui, Central African Republic. Pan Afr Med J 2016; 23: 237.
  13. White NJ. Mechanisms of trauma-induced coagulopathy. ASH Education Book 2013; 2013 (1): 660-3.
  14. Hess JR, Brohi K, Dutton RP, Hauser CJ, Holcomb JB, Kluger Y, et al. The coagulopathy of trauma: a review of mechanisms. J Trauma 2008; 65(4): 748-54.
  15. De Robertis E, Kozek-Langenecker SA, Tufano R, Romano GM, Piazza O, Zito MG. Coagulopathy induced by acidosis, hypothermia and hypocalcaemia in severe bleeding. Minerva Anestesiol 2015; 81(1): 65-75.
  16. Palmer L, Martin L. Traumatic coagulopathy-Part 1: Pathophysiology and diagnosis. J Vet Emerg Crit Care 2014; 24(1): 63-74.
  17. Matsumoto H, Mashiko K, Sakamoto Y, Kutsukata N, Hara Y, Yokota H. A new look at criteria for damage control surgery. J Nippon Med Sch 2010; 77(1): 13-20.
  18. Cohen MJ, Kutcher ME. Coagulopathy associated with trauma [Online]. [cited 2016 Aug 29]; Available from: URL:
  19. https://www.uptodate.com/contents/coagulopathy-associated-with-trauma
Journal of Isfahan Medical School
Volume 35, Issue 420 - Serial Number 420
January and February 2017
Pages 135-142

Files

History

  • Receive Date: 12 June 2016
  • Revise Date: 06 May 2024
  • Accept Date: 06 April 2022

Share

How to cite

Statistics