Professor Sun Yat-sen Memorial Hospital，Sun Yat-sen University
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First Author: Kaidi Tao, n/a Co-Author: Fanrong Lin, n/a Co-Author: Teng Huang, n/a Co-Author: longyuan jiang, n/a – Professor, Sun Yat-sen Memorial Hospital，Sun Yat-sen University
Introduction: Acid-base disturbances are common in critically ill patients and are associated with poor clinical outcomes. This study aimed to compare the characteristics of acid-base disorders, oxygenation, perfusion status, and prognosis between a Chinese ICU population and the international MIMIC-III database.
Methods: We conducted a retrospective analysis of 7,140 arterial blood gas (ABG) samples from Sun Yat-sen Memorial Hospital ICU (2013–2023) and 52,662 samples from MIMIC-III. Acid-base disorders were classified using the six-step method. Oxygenation was assessed by PaO₂/FiO₂ ratio, and perfusion status by lactate levels. Statistical analyses were performed using R (v4.4.1).
Results: Significant differences were observed in acid-base disorder patterns between the cohorts. Our hospital cohort exhibited lower acidemia prevalence (23.73% vs. 34.38%) but higher alkalemia rates (25.27% vs. 14.14%). Metabolic acidosis was more prevalent in our cohort (73.38% vs. 62.24%), with shock as the leading cause of high-anion-gap metabolic acidosis (55.15% vs. 42.86% hyperglycemic crises in MIMIC-III). Over 50% of pH-normal patients had underlying imbalances, highlighting the limitations of relying solely on pH. Oxygenation and perfusion patterns also differed, with our cohort showing better outcomes.
Conclusions: This study reveals population-specific patterns in acid-base disorders, emphasizing the need for comprehensive ABG interpretation beyond pH alone. The higher alkalemia rates in our cohort suggest greater susceptibility to iatrogenic disturbances. These findings underscore the importance of tailored clinical approaches and region-specific reference standards in critical care.
