ESTABLISHING CORRELATION OF pH WITH VARIOUS PHYSIOCHEMICAL AND TRADITIONAL PARAMETERS OF ACID BASE BALANCE: A CROSS-SECTIONAL STUDY

Abstract

OBJECTIVE: To evaluate the effectiveness of Physiochemical versus traditional approach in diagnosing acid-base disorders (ABD). METHODS: This cross-sectional observational study was conducted on 212 patients, admitted during January to June 2020, in intensive care unit of Rehman Medical Institute, Peshawar, Pakistan. Samples were obtained from these patients for pH, PCO2, HCO3, lactate, Na, K and Cl processed on Cobas ABG analyzer b 221. Ca, Mg, albumin and phosphate were analyzed on Cobas-601. Data was analyzed to assess the association among different parameters in traditional and Physiochemical approach. RESULTS: Males were predominant in total cohort group (n=125/212; 59%) as well as in metabolic subgroup (n=109/184; 59%). Mean age of males and females was 55.01±11.80 years and 54.99±14.76 years respectively. pH showed a strong negative correlation with PO4 (p-value=0.001) (rs 0.238) in the total cohort of subjects and no significant correlation (p=0.005) (rs -.206) in the metabolic subgroup in physiochemical approach. In traditional approach acid base parameters, Standard Base Excess (SBE) showed strong positive correlation (p=0.001) (rs 0.413 and rs 0.567) and pCO2 showed the strongest negative correlation (p value 0.001) (rs value -0.721 and rs -0.673) with pH in both total cohort and metabolic subgroup. HCO3 (p=0.003) (rs value 0.221) and AG (p=0.024) (rs value -0.167) both showed a significant strong positive and strong negative correlation with pH respectively. CONCLUSION: No significant association between physiochemical parameters and blood pH was found in adults. Traditional approach is the simplest, most rigorous, and useful for diagnosing ABD.

Keywords

• stewart approach
• acid-base equilibrium
• anion gap
• acid-base imbalance
• acidosis
• alkalosis
• hydrogen ion concentration
• blood
• body fluids
• fluid shifts