• Crit Care Resusc · Mar 2022

    Clinical outcomes of Indigenous Australians and New Zealand Māori with metabolic acidosis and acidaemia.

    • NetoAry SerpaASAustralian and New Zealand Intensive Care Research Centre, School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC, Australia.Department of Critical Care, Melbourne Medical School, University of Melbourne, Austin , Tomoko Fujii, James Moore, Paul J Young, Sandra Peake, Michael Bailey, Carol Hodgson, Alisa M Higgins, Emily J See, Paul Secombe, Vanessa Russ, Lewis Campbell, Meredith Young, Mikihiro Maeda, David Pilcher, Jamie Cooper, and Andrew Udy.
    • Australian and New Zealand Intensive Care Research Centre, School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC, Australia.
    • Crit Care Resusc. 2022 Mar 7; 24 (1): 141914-19.

    AbstractObjective: To assess the incidence and impact of metabolic acidosis in Indigenous and non-Indigenous patients Design: Retrospective study. Setting: Adult intensive care units (ICUs) from Australia and New Zealand. Participants: Patients aged 16 years or older admitted to an Australian or New Zealand ICU in one of 195 contributing ICUs between January 2019 and December 2020 who had metabolic acidosis, defined as pH < 7.30, base excess (BE) < -4 mEq/L and PaCO2 ≤ 45 mmHg. Main outcome measures: The primary outcome was the prevalence of metabolic acidosis. Secondary outcomes included ICU length of stay, hospital length of stay, receipt of renal replacement therapy (RRT), major adverse kidney events at 30 days (MAKE30), and hospital mortality. Results: Overall, 248 563 patients underwent analysis, with 11 537 (4.6%) in the Indigenous group and 237 026 (95.4%) in the non-Indigenous group. The prevalence of metabolic acidosis was higher in Indigenous patients (9.3% v 6.1%; P < 0.001). Indigenous patients with metabolic acidosis received RRT more often (28.2% v 22.0%; P < 0.001), but hospital mortality was similar between the groups (25.8% in Indigenous v 25.8% in non-Indigenous; P = 0.971). Conclusions: Critically ill Indigenous ICU patients are more likely to have a metabolic acidosis in the first 24 hours of their ICU admission, and more often received RRT during their ICU admission compared with non-Indigenous patients. However, hospital mortality was similar between the groups.© 2022 College of Intensive Care Medicine of Australia and New Zealand.

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