Original Contribution
Sociodemographic and Etiological Profile of Patients with Metabolic Acidosis Admitted in an Intensive Care Unit of a Specialized Hospital in Bangladesh
*Rahman MM,1 Islam U,2 Mamun AA3
- *Dr. Md Muhibur Rahman, FCPS (Medicine), FCPS (Gastroenterology), Medical Officer, Department of Gastroenterology, Sylhet MAG Osmani Medical College Hospital, Sylhet, Bangladesh. dmc@gmail.com
- Ummehoney Islam, MD (Dermatology), Resident, Sylhet MAG Osmani Medical College Hospital, Sylhet, Bangladesh
- Abdullah Al Mamun, FCPS (Medicine), Senior Consultant, Department of Medicine, Evercare Hospital, Dhaka, Bangladesh
*For correspondence
Abstract
Background: Metabolic acidosis is a serious acid-base disorder frequently encountered in intensive care units (ICUs). Early diagnosis and management of its underlying causes are crucial for improving patient outcomes. However, there is a paucity of local data on the etiologies of metabolic acidosis among critically ill patients in Bangladesh.
Objectives: To determine the causes of metabolic acidosis and distinguish the etiologies associated with an elevated anion gap from those with a normal anion gap among patients admitted to the Medical ICU of a specialized hospital in Bangladesh.
Methods: This hospital-based observational study was conducted at the Medical ICU of Evercare Hospitals, Dhaka, Bangladesh, from March 2012 to August 2012. Fifty patients diagnosed with metabolic acidosis were enrolled. Data on patient demographics, comorbidities, clinical features, and biochemical investigations were collected.
Results: The mean age of patients was 58.04 years, with a predominance of males (68%). Renal failure was the most common cause of metabolic acidosis (58%), followed by lactic acidosis (28%), diabetic ketoacidosis (6%), and methanol poisoning (6%). The majority (82%) had high anion gap metabolic acidosis. Hypoalbuminemia was observed in 62% of patients.
Conclusion: Metabolic acidosis more commonly occurred in patients with renal failure, particularly in the sixth and seventh decades of life, with a male predominance and higher prevalence among individuals from higher socioeconomic backgrounds. Causes of high anion gap metabolic acidosis were more common than normal anion gap acidosis in ICU patients. Prompt diagnosis and management of the underlying etiology are crucial for improving outcomes.
[Shaheed Syed Nazrul Islam Med Col J 2024, Jul; 9 (2):94-102]
doi: https://doi.org/10.69699/ssnimcj2024v9i2a8
Keywords: Metabolic acidosis, anion gap, intensive care unit, Bangladesh, etiology
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