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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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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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Item Type: Article
Status: Published
CreatorsEmailPitt UsernameORCID
Zampieri, FG
Kellum, JAkellum@pitt.eduKELLUM0000-0003-1995-2653
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


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