DOI: 10.1097/01.ccm.0000474812.30183.54

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Issn Print: 0090-3493

Publication Date: 2015/12/01


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984: ANION GAP AS A PREDICTIVE VALUE FOR CLINICAL OUTCOME IN CRITICALLY ILL CHILDREN

Alicia Fernández; Jennifer Ruiz; Nilka De Jesús; Janice Gómez-Garay; Anabel Puig-Ramos; Ihosvani Barroso

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Excerpt

Learning Objectives: Plasma anion gap and delta anion gap have a great significance in the clinical diagnosis of a variety of acid-base disorders and are particularly useful for evaluating patients with mixed metabolic acidosis. In adults, studies have shown that a high Anion Gap (AG) is a good predictor of mortality in critically ill patients. However, in critically ill children it has not been established.
Methods: Retrospective observational study including patients, 0 to 21 yr old, admitted to the Pediatric Intensive Care Unit (PICU) at the University Pediatric Hospital from January to November of 2010. Admission anion gap was calculated and evaluated patient’s clinical outcome. Mann-Whitney and Fisher exact test was used for statistical analysis.
Results: A total of 201 patients meet the inclusion criteria; 42% (84) were female, median age was 7.5 yr (~6.1), mechanical ventilation days were 12 days (~17) and the overall mortality was 9% (18 patients). Patients with elevated AG had more mechanical ventilation days, 7 (4–8) p =0.035. Also, patients with elevated AG had increased mortality, 15% (10/65) p=0.027.
Conclusions: Data suggest that elevated AG in children critically ill can be use as a predictor of mortality and mechanical ventilation days. Elevated AG must be compared with other mortality score predictors in pediatric critical care setting such as PRISM or PIM Score to determine if there is a correlation with high AG values with high PRISM or PIM score. We are currently analyzing which predictor of mortality score best correlates with an elevated AG at the pediatric critical care setting.
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