Identifying the sick: Can biochemical measurements be used to aid decision making on presentation to the accident and emergency department

British Journal of Anaesthesia

Volumn 94, Issue 6, 2005, Pages 735-741

  Hucker, T R ^a   Mitchell, G P ^a   Blake, L D ^a   Cheek, E ^b   Bewick, V ^b   Grocutt, M ^a   Forni, L G ^a   Venn, Richard M ^a  

^a WORTHING HOSPITAL   (United Kingdom)

^b UNIVERSITY OF BRIGHTON   (United Kingdom)

Author keywords

Audit, accident and emergency; Clinical observations; Complications, mortality; Hospital stay; Outcome; Physiology, abnormal

Indexed keywords

ALBUMIN; BASE; BICARBONATE; CALCIUM ION; CHLORIDE ION; CREATININE; LACTIC ACID; PHOSPHATE; POTASSIUM ION; SODIUM ION; UREA;

ACCURACY; ADULT; AGE; AGED; AMBIENT AIR; ANION GAP; AREA UNDER THE CURVE; ARTICLE; BIOCHEMISTRY; BLOOD ANALYSIS; BODY TEMPERATURE; BREATHING RATE; CLINICAL EXAMINATION; CLINICAL FEATURE; CLINICAL OBSERVATION; CONSCIOUSNESS; CONTROLLED STUDY; DETERIORATION; EMERGENCY HEALTH SERVICE; EMERGENCY WARD; GENERAL HOSPITAL; HEART RATE; HOSPITAL ADMISSION; HOSPITAL BED CAPACITY; HUMAN; LENGTH OF STAY; LOGISTIC REGRESSION ANALYSIS; MAJOR CLINICAL STUDY; MEDICAL ASSESSMENT; MEDICAL DECISION MAKING; METABOLIC PARAMETERS; MORTALITY; OUTCOMES RESEARCH; OXYGEN SATURATION; PARSIMONY ANALYSIS; PH; PREDICTION; PRIORITY JOURNAL; PROSPECTIVE STUDY; RECEIVER OPERATING CHARACTERISTIC; RISK ASSESSMENT; SURVIVAL; SYSTOLIC BLOOD PRESSURE; VENOUS BLOOD;

EID: 19944390228     PISSN: 00070912     EISSN: None     Source Type: Journal    
DOI: 10.1093/bja/aei122     Document Type: Article

References (23)

1. Rivers E, Nguyen B, Havstad S, et al. Early goal-directed therapy in the treatment of severe sepsis and septic shock. N Engl J Med 2001; 345:1368-77
2. Bland RD, Shoemaker WC, Abraham E, Cobo JC. Hemodynamic and oxygen transport patterns in surviving and nonsurviving post-operative patients. Crit Care Med 1985; 13: 85-90
3. Fencl V, Jabor A, Kazda A, Figge J. Diagnosis of metabolic acid-base disturbances in critically ill patients. Am J Respir Crit Care Med 2000; 162: 2246-51
4. Smith I, Kumar P, Molloy S, et al. Base excess and lactate as prognostic indicators for patients admitted to intensive care. Intensive Care Med 2001; 27: 74-83
5. Bernardin G, Pradier C, Tiger F, Deloffre P, Mattei M. Blood pressure and arterial lactate level are early indicators of short-term survival in septic shock. Intensive Care Med 1996; 22: 17-25
6. Waldau T, Larsen VH, Bonde J, Fogh-Andersen N. Lactate, pH, and blood gas analysis in critically ill patients. Acta Anaesthesiol Scand 1995; 39: 267-71
7. Stewart PA. Modern quantitative acid-base chemistry. Can J Physiol Pharmacol 1983; 61: 1444-6
8. Fencl V, Leith DA. Stewart's quantitative acid-base chemistry: applications in biology and medicine. Respir Physiol 1993; 91: 1-16
9. Sirker AA, Rhodes A, Grounds RM, Bennett ED. Acid-base physiology: the 'traditional' and the 'modern' approaches. Anaesthesia 2002; 57: 348-56
10. Gilfix BM, Bique M, Magder S. A physical chemical approach to the analysis of acid-base balance in the clinical setting. J Crit Care 1993; 8: 187-97
11. Kellum AJ, Kramer DJ, Pinsky MR. Strong ion gap: a methodology for exploring unexplained anions. J Crit Care 1995; 10: 51-5
12. Cusack RJ, Rhodes A, Lochhead P, et al. The strong ion gap does not have prognostic value in critically ill patients in a mixed medical/surgical adult ICU. Intensive Care Med 2002; 28: 864-9
13. Morgan TJ, Venkatesh B, Hall J. Crystalloid strong ion difference determines metabolic acid-base change during in vitro hemodilution. Crit Care Med 2002; 30: 259-61
14. UK Department of Health. Comprehensive Critical Care: a Review of Adult Critical Care Services 2000. Available online at www.doh.gov.uk/pdfs/criticalcare. pdf
15. Stenhouse C, Coates S, Tivey M, Allsop P, Parker T. Prospective evaluation of modified early warning score to aid earlier detection of patients developing critical illness on a general surgical ward. Br J Anaesth 2000; 84: 663P.
16. Ridley S. Severity of illness scoring systems and performance appraisal. Anaesthesia 1998; 53: 1185-94
17. Anonymous. Guidelines for the management of adults with community-acquired pneumonia. Am J Respir Crit Care Med 2001; 163: 1730-54
18. Chumbley GM, Hall GM. Recovery after major surgery: does the anaesthetic make any difference? Br J Anaesth 1997; 78: 347-8.
19. Kelly A-M, McAlpine R, Kyle E. Venous pH can safely replace arterial pH in the initial evaluation of patients in the emergency department. Emerg Med 2001; 18: 340-2
20. Gennis PR, Skovron ML, Aronson ST, Gallagher EJ. The usefulness of peripheral venous blood in estimating acid-base status in acutely ill patients. Ann Emerg Med 1985; 14: 845-9
21. Gokel Y, Paydas S, Koseoglu Z, Alparsian N, Seydaoglu G. Comparison of blood gas and acid-base measurements in arterial and venous blood samples in patients with uremic acidosis and diabetic ketoacidosis in the emergency room. Am J Nephrol 2000; 20: 319-23
22. Ma OJ, Rush MD, Godfrey MM, Gaddis G. Arterial blood gas results rarely influence emergency physician management of patients with suspected diabetic ketoacidosis. Acad Emerg Med 2003; 10: 836-41
23. Brandenburg MA, Dire DJ. Comparison of arterial and venous blood gas values in the initial emergency department evaluation of patients with diabetic ketoacidosis. Ann Emerg Med 1998; 31; 459-65.