Abstract
Background: The acid-base balance may alter in postoperative critically ill patients. This retrospective observational study was conducted to determine the degree and cause of acid-base derangements using Stewart-approach. Methods: Sixty post-esophagectomy patients who required intensive care for at least 7 days were included in this study. We measured all relevant variables for acid-base analysis according to the Stewart-approach from postoperative day (POD) 1 to POD 6. The study was approved by the local institutional ethics committee. Results: After admission to the ICU, patients developed metabolic alkalosis with mild elevated carbon dioxide (P<0.01). This change was mostly secondary to an increase in strong ion difference apparent (SIDa) (delta SIDa: +5.3 mmol/l, P<0.01) due to decrease in chloride levels (Cl) (delta Cl: -3.9 mmol/l, P<0.01). Conclusions: Most of the post-esophagectomy patients developed metabolic alkalosis, which was mainly secondary to an increase in strong ion difference due to decreased chloride. The Stewart-approach is a useful tool for acid-base analysis.
