Relationship between acid-base status and inflammation in the critically ill

Zampieri, FG and Kellum, JA and Park, M and Ranzani, OT and Barbeiro, HV and de Souza, HP and da Cruz Neto, LM and Pinheiro da Silva, F (2014) Relationship between acid-base status and inflammation in the critically ill. Critical Care, 18 (4). ISSN 1364-8535

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Abstract

Introduction: There is a complex interplay between changes in acid-base components and inflammation. This manuscript aims to explore associations between plasma cytokines and chemokines and acid-base status on admission to intensive care. Methods: We conducted a prospective cohort study in a 13-bed ICU in a tertiary-care center in Brazil. 87 unselected patients admitted to the ICU during a 2-year period were included. We measured multiple inflammatory mediators in plasma using multiplex assays and evaluated the association between mediator concentrations and acid-base variables using a variety of statistical modeling approaches, including generalized linear models, multiadaptive regression splines and principal component analysis. Results: We found a positive association between strong ion gap (SIG) and plasma concentrations of interleukin (IL)6, 8, 10 and tumor necrosis factor (TNF); whereas albumin was negatively associated with IL6, IL7, IL8, IL10, TNF and interferon (IFN)α. Apparent strong ion difference (SIDa) was negatively associated with IL10 and IL17. A principal component analysis including SAPS 3 indicated that the association between acid-base components and inflammatory status was largely independent of illness severity, with both increased SIG and decreased SIDa (both drivers of acidosis) associated with increased inflammation. Conclusion: Acid-base variables (especially increased SIG, decreased albumin and decreased SIDa) on admission to ICU are associated with immunological activation. These findings should encourage new research into the effects of acid-base status on inflammation.

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Details

Item Type:	Article
Status:	Published
Creators/Authors:	Creators Email Pitt Username ORCID Zampieri, FG Kellum, JA kellum@pitt.edu KELLUM 0000-0003-1995-2653 Park, M Ranzani, OT Barbeiro, HV de Souza, HP da Cruz Neto, LM Pinheiro da Silva, F
Date:	17 July 2014
Date Type:	Publication
Journal or Publication Title:	Critical Care
Volume:	18
Number:	4
DOI or Unique Handle:	10.1186/cc13993
Schools and Programs:	School of Medicine > Critical Care Medicine
Refereed:	Yes
ISSN:	1364-8535
Date Deposited:	19 Sep 2016 15:45
Last Modified:	22 Jun 2021 14:55
URI:	http://d-scholarship.pitt.edu/id/eprint/29511

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