| Title: |
Relationship between acid-base status and inflammation in the critically ill |
| Authors: |
Zampieri, FG; Kellum, JA; Park, M; Ranzani, OT; Barbeiro, HV; de Souza, HP; da Cruz Neto, LM; Pinheiro da Silva, F |
| Publication Year: |
2014 |
| Collection: |
University of Pittsburgh: D-Scholarship@Pitt |
| Description: |
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. |
| Document Type: |
article in journal/newspaper |
| File Description: |
application/pdf; text/plain |
| Language: |
English |
| ISSN: |
1364-8535 |
| Relation: |
https://d-scholarship.pitt.edu/29511/1/art%253A10.1186%252Fcc13993.pdf; https://d-scholarship.pitt.edu/29511/7/licence.txt; 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 |
| Availability: |
https://d-scholarship.pitt.edu/29511/ |
| Rights: |
attached |
| Accession Number: |
edsbas.AB1DF132 |
| Database: |
BASE |