Respiratory failure & ventilation
Impact of mild hypercapnia in critically ill patients with metabolic acidosis
Main findingResult — go to the resultOdds ratio 0.79 95 % CI 0.69–0.90Authors' conclusion
In patients with metabolic acidosis, after adjustment for potential confounders, mild hypercapnia does not increase the MAKE-30 rate and does not have a major impact on pH.
Study context
- Population
- Critically ill patients with metabolic acidosis and concurrent vasopressor requirement, 12 intensive care units (ICUs) in Queensland, Australia
- Participants
- 5,601 patients
- Exposure
- PaCO2 46-50 mmHg vs PaCO2 ≤ 45 mmHg
- PaCO2 46-50 mmHgn = 1,996
- PaCO2 ≤ 45 mmHgn = 3,605reference
- Outcome
- Major adverse kidney events (MAKE30)
- Follow-up
- 30 days
Methodological detailsmulticentre, 12 ICUs
- Multicentre
- 12 ICUs
Main finding
As reported in the abstract
Odds ratio
0.79
95 % CI 0.69–0.90
P < 0.001
By group
PaCO2 46-50 mmHg vs PaCO2 ≤ 45 mmHg
OR 0.79 (95 % CI 0.69–0.90); P < 0.001
Observational data: associations, not effects.
Further findings
- Maximum fall of pH per 1 mmHg increase in PaCO2 (PaCO2 46-50 mmHg)
- 0.006
RRT use and AKI incidence
- Lower in the PaCO2 46-50 mmHg group (unadjusted); not different after adjustment
Original publication
Impact of mild hypercapnia in critically ill patients with metabolic acidosis. J Crit Care. Published 20 October 2024. doi:10.
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