DefinePK

Abstract

Background & Objective: Sepsis is a major global health threat, and it is especially true for low- and middle-income countries. Sepsis may be a result of deteriorated acid-base balance, or it may lead to such an imbalance in its own right. Both conditions pose a major challenge in the intensive care unit (ICU) patients. This study investigates the impact of acid-base disorder on the severity of sepsis and its associated mortality in critically ill patients.
Methodology: A retrospective cohort study was conducted covering the period from December 2022 to December 2023 at Jinnah Post Graduate Medical Centre, Karachi, Pakistan. We included 144 patients admitted to the medical Intensive care unit (ICU)/High dependency unit (HDU) with suspected sepsis, based upon laboratory investigations and physical signs. Acid-base disorders were investigated using arterial blood gas analyses. Outcomes were determined as mortalities and the length of ICU/HDU stay. Appropriate statistical tests such as chi-square or Fisher exact tests for categorical variables and t-test for continuous variables, were used. P < 0.05 was considered to be statistically significant.
Results: Out of 144 patients, 71 (49.3%) participants had metabolic acidosis categorized as mild (29.8%), moderate (16.6%) and severe (2.8%). In contrast, 39 patients (27.1%) had metabolic alkalosis, categorized as mild (20.8%) and moderate (6.3%). Additionally, 34 (23.6%) patients had a normal acid-base status. The pH differed significantly between acid-base groups (P = 0.000). Overall mortality was 31.3% (n = 45). Notably, patients with severe metabolic acidosis exhibited a 100% mortality rate compared to only 20.59% among those with normal acid-base status. Serum lactate was the only significant prognostic marker in this study (P < 0.05).
Conclusion: This study shows that acid-base imbalance in sepsis is significantly linked to mortality, with severe metabolic acidosis yielding 100% mortality. It also demonstrates serum lactate as a crucial prognostic marker.
Abbreviations: HDU: High dependency unit, ICU: Intensive care unit, SIRS: Systemic Inflammatory Response Syndrome, SOFA: Sequential Organ Failure Assessment
Keywords: Acid-base disorder; Base excess; Intensive Care Unit; Lactic acidosis; Length of stay; Metabolic Acidosis; Metabolic Alkalosis; Mortality; pH; Sepsis
Citation: Kausar S, Advani R, Ali Z, Batool W. Prevalence of acid-base disorders and impact on outcome in sepsis in critically ill patients: A retrospective cohort study. Anaesth. pain intensive care 2025;29(7):764-769. DOI: 10.35975/apic.v29i7.2952
Received: September 26, 2024; Revised: May 29, 2025; Accepted: September 02, 2025