Strong Ion Gap as Prognostic Indicator for Adult Patients Admitted With Shock to the Intensive Care Units

NCT02652364 | Completed

• 1 other identifier: 2015/2423
• Study Type: observational
• Target: 112
• Locations: 1 country
• Sites: 1

Brief Summary

This study evaluates if strong ion gap on admission or 24 hours after admission to critical care unit can predict 28 day outcome in patients admitted with shock due to any cause

Conditions

Shock

Outcome Measures

Primary Outcomes (1)

• mortality

  28 days

Secondary Outcomes (1)

• Duration of ICU stay

  28 days

Eligibility Criteria

• Age: 21 Years - 99 Years
• Sex: all
• Healthy Volunteers: No
• Age Groups: Adult (18-64), Older Adult (65+)
• Sampling Method: Non-Probability Sample

Study Population

Patient with any form of shock on admission to ICU defined by those who require vasopressors or inotropes to maintain MAP \> 65mmHg on admission

You may qualify if:

• Patient with any form of shock on admission to ICU

You may not qualify if:

• CKD stage 3 and above (GFR\> 60)
• Chronic liver failure( Child's B grade and above)
• Patients who were already recruited for this study
• Patients expected to die within next 48 hrs upon admission

Sponsors & Collaborators

• Singapore General Hospital: lead
• Changi General Hospital: collaborator

Study Sites (1)

Singapore General Hospital

Singapore, 169608, Singapore

Location

Related Publications (17)

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  PMID: 2026034 RESULT

• Figge J, Mydosh T, Fencl V. Serum proteins and acid-base equilibria: a follow-up. J Lab Clin Med. 1992 Nov;120(5):713-9.

  PMID: 1431499 RESULT

• Figge J, Jabor A, Kazda A, Fencl V. Anion gap and hypoalbuminemia. Crit Care Med. 1998 Nov;26(11):1807-10. doi: 10.1097/00003246-199811000-00019.

  PMID: 9824071 RESULT

• Stewart PA. Modern quantitative acid-base chemistry. Can J Physiol Pharmacol. 1983 Dec;61(12):1444-61. doi: 10.1139/y83-207.

  PMID: 6423247 RESULT

• Kellum JA, Kramer DJ, Pinsky MR. Strong ion gap: a methodology for exploring unexplained anions. J Crit Care. 1995 Jun;10(2):51-5. doi: 10.1016/0883-9441(95)90016-0.

  PMID: 7647842 RESULT

• Gunnerson KJ. Clinical review: the meaning of acid-base abnormalities in the intensive care unit part I - epidemiology. Crit Care. 2005 Oct 5;9(5):508-16. doi: 10.1186/cc3796. Epub 2005 Aug 10.

  PMID: 16277740 RESULT

• Kellum JA. Closing the gap on unmeasured anions. Crit Care. 2003 Jun;7(3):219-20. doi: 10.1186/cc2189. Epub 2003 May 8.

  PMID: 12793870 RESULT

• Rutherford EJ, Morris JA Jr, Reed GW, Hall KS. Base deficit stratifies mortality and determines therapy. J Trauma. 1992 Sep;33(3):417-23. doi: 10.1097/00005373-199209000-00014.

  PMID: 1404512 RESULT

• Smith I, Kumar P, Molloy S, Rhodes A, Newman PJ, Grounds RM, Bennett ED. Base excess and lactate as prognostic indicators for patients admitted to intensive care. Intensive Care Med. 2001 Jan;27(1):74-83. doi: 10.1007/s001340051352.

  PMID: 11280677 RESULT

• Balasubramanyan N, Havens PL, Hoffman GM. Unmeasured anions identified by the Fencl-Stewart method predict mortality better than base excess, anion gap, and lactate in patients in the pediatric intensive care unit. Crit Care Med. 1999 Aug;27(8):1577-81. doi: 10.1097/00003246-199908000-00030.

  PMID: 10470767 RESULT

• Kaplan LJ, Kellum JA. Initial pH, base deficit, lactate, anion gap, strong ion difference, and strong ion gap predict outcome from major vascular injury. Crit Care Med. 2004 May;32(5):1120-4. doi: 10.1097/01.ccm.0000125517.28517.74.

  PMID: 15190960 RESULT

• Funk GC, Doberer D, Sterz F, Richling N, Kneidinger N, Lindner G, Schneeweiss B, Eisenburger P. The strong ion gap and outcome after cardiac arrest in patients treated with therapeutic hypothermia: a retrospective study. Intensive Care Med. 2009 Feb;35(2):232-9. doi: 10.1007/s00134-008-1315-1. Epub 2008 Oct 14.

  PMID: 18853143 RESULT

• Noritomi DT, Soriano FG, Kellum JA, Cappi SB, Biselli PJ, Liborio AB, Park M. Metabolic acidosis in patients with severe sepsis and septic shock: a longitudinal quantitative study. Crit Care Med. 2009 Oct;37(10):2733-9. doi: 10.1097/ccm.0b013e3181a59165.

  PMID: 19885998 RESULT

• Cusack RJ, Rhodes A, Lochhead P, Jordan B, Perry S, Ball JA, Grounds RM, Bennett ED. The strong ion gap does not have prognostic value in critically ill patients in a mixed medical/surgical adult ICU. Intensive Care Med. 2002 Jul;28(7):864-9. doi: 10.1007/s00134-002-1318-2. Epub 2002 Jun 14.

  PMID: 12122523 RESULT

• Rocktaeschel J, Morimatsu H, Uchino S, Bellomo R. Unmeasured anions in critically ill patients: can they predict mortality? Crit Care Med. 2003 Aug;31(8):2131-6. doi: 10.1097/01.CCM.0000079819.27515.8E.

  PMID: 12973170 RESULT

• Hayhoe M, Bellomo R, Liu G, McNicol L, Buxton B. The aetiology and pathogenesis of cardiopulmonary bypass-associated metabolic acidosis using polygeline pump prime. Intensive Care Med. 1999 Jul;25(7):680-5. doi: 10.1007/s001340050930.

  PMID: 10470571 RESULT

• Gunnerson KJ, Srisawat N, Kellum JA. Is there a difference between strong ion gap in healthy volunteers and intensive care unit patients? J Crit Care. 2010 Sep;25(3):520-4. doi: 10.1016/j.jcrc.2009.11.001. Epub 2009 Nov 25.

  PMID: 19942401 RESULT

MeSH Terms

Conditions

Shock

Condition Hierarchy (Ancestors)

Pathologic Processes; Pathological Conditions, Signs and Symptoms

Study Design

• Study Type: observational
• Observational Model: CASE ONLY
• Time Perspective: PROSPECTIVE
• Sponsor Type: OTHER
• Responsible Party: SPONSOR

Study Record Dates

• First Submitted: January 7, 2016
• First Posted: January 11, 2016
• Study Start: October 1, 2015
• Primary Completion: October 1, 2017
• Study Completion: October 1, 2017
• Last Updated: March 19, 2020

Record last verified: 2020-03

Locations

SG (1)