Publication:

Assessment of the acid-base disturbance in COVID-19 patients admitted in an intensive care unit: an observational study

Background The coronavirus disease 2019, known as COVID-19, became a global pandemic following its initial outbreak in Wuhan, China. COVID-19 illness severity is categorized into three levels: mild, severe, or critical. Arterial blood gas (ABG) testing is considered the definitive method for assessing oxygen levels. It also plays a crucial role in evaluating the sufficiency of ventilation and the balance of acids and bases in the body. To assess the acid base disturbance in COVID 19 patients who were admitted in the intensive care unit (ICU).

Methods After obtaining ethical committee approval and informed consent from patients this prospective observational study was conducted in a tertiary care hospital, Bengaluru from August 1st to October 31st 2020. The arterial blood gas tests were performed prior to any intervention to manage the patient's condition. The analyses focused on the anion gap, bicarbonate levels, blood pH, PaCO2, and PaO2.

Results The mean age of the patients was 58+12.2 years. A high pH level (alkalosis) was observed in 31 (62%) patients. High HCO3 was seen in 14 (28%). A statistical analysis using the Pearson correlation test revealed a significant negative correlation between PaCO2 and pH, with a correlation coefficient (r) of -0.346 and a p value of 0.001.

Conclusion Consistent monitoring of ABG at regular intervals plays a crucial role in promptly detecting respiratory impairment, silent hypoxia, and cytokine storms. Early identification through such monitoring can lead to timely intervention and ultimately save lives.