Metabolic alkalosis acquired in intensive care: A retrospective cohort study
Authors' conclusion
Metabolic alkalosis develops commonly in the ICU, but its association with increased mortality may be attributable to other confounding factors.
Study context
- Population
- Admissions to 12 intensive care unit (ICUs) in Queensland, Australia, 2015–2021, excluding readmissions, metabolic alkalosis within the first 24 h and ICU length of stay (LOS) ≤48 h
- Participants
- 24,676 eligible admissions
- Outcome
- Cumulative incidence of metabolic alkalosis during ICU admission
Methodological detailsmulticentre
- Multicentre
Main finding
As reported in the abstract
Eligible admissions
36%
8889 events
Observational data: associations, not effects.
Secondary outcomes
Time to first development of metabolic alkalosis
- Median time to first development in the ICU, days (IQR 3-6 days)
- four days
Potential underlying causes
- Diuretics
- 28%
- Steroids
- 24%
- No cause identified
- more than 40%
Mortality
- Increased mortality rates with metabolic alkalosis after adjustment for immortal time bias
- Not an independent predictor of outcome after adjusting for disease severity and comorbidities (multivariable analysis)
Original publication
Metabolic alkalosis acquired in intensive care: A retrospective cohort study. Anaesth Crit Care Pain Med. Published 9 July 2025. doi:10.
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