Respiratory failure & ventilation
Combining the Physical–Chemical Approach with Standard Base Excess to Understand the Compensation of Respiratory Acid–Base Derangements: An Individual Participant Meta-analysis Approach to Data from Multiple Canine and Human Experiments
Pooled result · Bicarbonate change vs strong ion difference variation (acute and chronic)Result — go to the resultΒ-coefficient 1.2 95% CI 1.2–1.3Authors' conclusion
The bicarbonate adaptation that follows primary respiratory alterations is associated with variations of strong ion difference. In the acute phase, the variation in strong ion difference is mainly due to sodium variations and is not paralleled by modifications of standard base excess. In the chronic setting, strong ion difference changes are due to chloride variations and are mirrored by standard base excess.
Study context
- Population
- Canine and human experiments testing acute or chronic respiratory derangements, reporting PaCO2, bicarbonate and electrolytes, published up to April 29, 202111 studies
- Comparison
- Acute vs chronic respiratory acid-base derangements
- Outcome
- Association of bicarbonate with strong ion difference during respiratory derangements; association of strong ion difference changes with standard base excess
Pooled result
As reported in the abstract
Β-coefficient
1.2
95% CI 1.2–1.3
P < 0.001
Further pooled results
Strong ion difference variation vs standard base excess changes
| β-coefficient (95% CI) | P value | |
|---|---|---|
| AcuteNot associated | −0.02 (−0.11 to 0.07) | P = 0.719 |
| ChronicPositive linear association | 1.04 (0.84–1.24) | P < 0.001 |
Determinants of strong ion difference change
- Acute: sodium variations justified ≈80% of strong ion difference change
- Chronic: a similar percentage of chloride variation responsible
Ranges of PaCO2, bicarbonate and strong ion difference
- PaCO2 range (mmHg)
- 21 and 142
- Bicarbonate range (mM)
- 12.3 and 43.8
- Strong ion difference range (mEq/l)
- 32.6 and 60.0
Original publication
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