ArticleIntensive care medicine2015
Increased serum bicarbonate in critically ill patients: a retrospective analysis.
Article in Intensive care medicine, 2015. The graph could read no effect estimate from its abstract, so it casts no vote on the map. An erratum has been issued. Cited by 9 papers.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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Who cites it
9 citing papers in PubMed, 37 citations in OpenAlex.
- The prognostic significance of the mechanism of mild to moderate alkalemia at emergency department admission.BMC emergency medicine · 2026Article
- Evolutive acid-base derangements in critically ill patients: epidemiological aspects, association with mortality and metabolic acidosis prediction.Critical care science · 2026Article
- Association of serum bicarbonate with 28-day and 90-day mortality in patients with epilepsy and concurrent sepsis: a retrospective cohort study.Frontiers in neurology · 2025Article
- The Effect of Extreme Alkalemia upon Presentation to the Emergency Department on Patient Outcomes.Journal of clinical medicine · 2024Article
- Metabolic alkalosis: a new red flag in status epilepticus.Journal of neurology · 2024Observational
- Identification of key predictors of hospital mortality in critically ill patients with embolic stroke using machine learning.Bioscience reports · 2022Article
- Significant Clinical Factors Associated with Long-term Mortality in Critical Cancer Patients Requiring Prolonged Mechanical Ventilation.Scientific reports · 2017Article
- The U-Shaped Relationship Between Serum Bicarbonate Levels and 28-Day Mortality in Patients With Sepsis: A Retrospective Cohort Study of MIMIC-IV Database.Dose-response : a publication of International Hormesis SocietyArticle
- [Severity of disease scoring systems and mortality after non-cardiac surgery].Brazilian journal of anesthesiology (Elsevier)Article
Corrections and comments
- Erratum issued
Authors and funding
6 authors at 4 institutions in 3 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
purposeAlthough metabolic alkalosis is a common occurrence, no study has evaluated its prevalence, associated factors or outcomes in critically ill patients.
methodsThis is a retrospective study from the Multiparameter Intelligent Monitoring in Intensive Care II database. From 23,529 adult patient records, 18,982 patients met the inclusion criteria.
resultsSerum bicarbonate levels demonstrated a U-shaped association with mortality with knots at 25 and 30 mEq/l. Of the total included patients, 5,565 (29.3 %) had at least one serum bicarbonate level measurement >30 mEq/l. The majority were exposed to multiple factors that are classically associated with metabolic alkalosis (mainly diuretic use, hypernatremia, hypokalemia and high gastric output). Patients with increased serum bicarbonate exhibited increased ICU LOS, more days on mechanical ventilation and higher hospital mortality. After multivariate adjustment, each 5-mEq/l increment in the serum bicarbonate level above 30 mEq/l was associated with an odds ratio of 1.21 for hospital mortality. The association between increased serum bicarbonate levels and mortality occurs independently of its possible etiologies.
conclusionAn increased serum bicarbonate level is common in critically ill patients; this can be attributed to multiple factors in the majority of cases, and its presence and duration negatively influence patient outcomes.
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