...
  • 主题
高级搜索  >
历史搜索 清空历史
首页> 外文期刊>Archives of disease in childhood >Correction of the anion gap for albumin in order to detect occult tissue anions in shock.
【24h】

Correction of the anion gap for albumin in order to detect occult tissue anions in shock.

机译：校正白蛋白的阴离子间隙，以检测休克中的隐匿组织阴离子。

获取原文
获取原文并翻译 | 示例
   

获取外文期刊封面封底 >>

       
页面导航
  • 摘要
  • 著录项
  • 相似文献
  • 相关主题

摘要

BACKGROUND: It is believed that hypoalbuminaemia confounds interpretation of the anion gap (AG) unless corrected for serum albumin in critically ill children with shock. Aim: To compare the ability of the AG and the albumin corrected anion gap (CAG) to detect the presence of occult tissue anions. METHODS: Prospective observational study in children with shock in a 22 bed multidisciplinary paediatric intensive care unit of a university childrenrsquo;s hospital. Blood was sampled at admission and at 24 hours, for acid-base parameters, serum albumin, and electrolytes. Occult tissue anions (lactate + truly "unmeasured" anions) were calculated from the strong ion gap. The anion gap ((Na + K) - (Cl + bicarbonate)) was corrected for serum albumin using the equation of Figge: AG + (0.25 x (44 - albumin)). Occult tissue anions (TA) predicted by the anion gap were calculated by (anion gap - 15 mEq/l). Optimal cut off values of anion gap were compared by means of receiver operating characteristic (ROC) curves. Ninety three sets of data from 55 children (median age 7 months, median weight 4.9 kg) were analysed. Data are expressed as mean (SD), and mean bias (limits of agreement). RESULTS: The incidence of hypoalbuminaemia was 76% (n = 42/55). Mean serum albumin was 25 g/l (SD 8). Mean AG was 15.0 mEq/l (SD 6.1), compared to the CAG of 19.9 mEq/l (SD 6.6). Mean TA was 10.2 mmol/l (SD 6.3). The AG underestimated TA with mean bias 10.2 mmol/l (4.1-16.1), compared to the CAG, mean bias 5.3 mmol/l (0.4-10.2). A clinically significant increase of TA >5 mmol/l was present in 83% (n = 77/93) of samples, of which the AG detected 48% (n = 36/77), and the CAG 87% (n = 67/77). Post hoc ROC analysis revealed optimal cut off values for detection of TA >5 mmol/l to be AG >10 mEq/l, and CAG >15.5 mEq/l. CONCLUSION: Hypoalbuminaemia is common in critically ill children with shock, and is associated with a low observed anion gap that may fail to detect clinically significant amounts of lactate and other occult tissue anions. We suggest that the albumin corrected anion gap should be calculated to screen for occult tissue anions in these children.
机译：背景：人们认为，除非校正了重症休克儿童的血清白蛋白，否则低白蛋白血症会混淆对阴离子间隙（AG）的解释。目的：比较AG和白蛋白校正的阴离子间隙（CAG）检测隐匿性组织阴离子的能力。方法：在一家大学儿童医院的22张床的多学科儿科重症监护室对休克患儿进行前瞻性观察研究。在入院时和24小时时对血液进行采样，以获取酸碱参数，血清白蛋白和电解质。从强离子间隙中计算出隐匿性组织阴离子（乳酸+真正的“未测”阴离子）。使用Figge：AG +（0.25 x（44-白蛋白））方程校正血清白蛋白的阴离子间隙（（Na + K）-（Cl +碳酸氢盐））。阴离子间隙预测的隐匿组织阴离子（TA）的计算公式为（阴离子间隙-15 mEq / l）。通过接收器工作特性（ROC）曲线比较了阴离子间隙的最佳截止值。分析了55名儿童（中位年龄7个月，中位体重4.9千克）的93份数据。数据表示为均值（SD）和均值偏差（一致性极限）。结果：低白蛋白血症的发生率为76％（n = 42/55）。平均血清白蛋白为25 g / l（SD 8）。平均AG为15.0 mEq / l（SD 6.1），而CAG为19.9 mEq / l（SD 6.6）。平均TA为10.2 mmol / l（SD 6.3）。与CAG相比，AG低估了TA的平均偏差10.2 mmol / l（4.1-16.1），CAG的平均偏差5.3 mmol / l（0.4-10.2）。在83％（n = 77/93）的样品中，TA> 5 mmol / l的临床显着增加，其中AG检测到48％（n = 36/77），CAG检测到87％（n = 67） / 77）。事后ROC分析显示，检测TA> 5 mmol / l的最佳临界值为AG> 10 mEq / l，CAG> 15.5 mEq / l。结论：低白蛋白血症常见于重症休克儿童，并伴有较低的阴离子间隙，可能无法检测出临床上大量的乳酸和其他隐匿性组织阴离子。我们建议应计算白蛋白校正的阴离子间隙，以筛查这些儿童的隐匿性组织阴离子。

著录项

相似文献

  • 外文文献
  • 中文文献
  • 专利
获取原文

客服邮箱：kefu@zhangqiaokeyan.com

京公网安备：11010802029741号 ICP备案号：京ICP备15016152号-6 六维联合信息科技 (北京) 有限公司©版权所有

  • 客服微信

  • 服务号