Acid-base and electrolyte abnormalities in febrile patients with bacteraemia (Journal article)

Elisaf, M. S./ Theodorou, J./ Pappas, H./ Siamopoulos, K. C.

OBJECTIVES: Very commonly febrile patients with bacteraemia develop a variety of acid-base and electrolyte disturbances which play a significant role in the morbidity and mortality of these patients. This study was undertaken to describe the pathogenetic mechanisms of these abnormalities in febrile patients with bacteraemia. METHODS: Fifteen febrile patients with bacteraemia, aged 24-62 years, were studied. In all patients blood cultures revealed Gram-negative rods. None of them had septic shock, diabetes mellitus, renal or liver failure and none was receiving drugs influencing acid-base balance and electrolyte levels or was a heavy alcohol consumer. RESULTS: Nine patients had respiratory alkalosis, which was possibly due to bacterial toxins, while the remaining 6 had a wide-gap metabolic (lactic) acidosis coexisting with respiratory alkalosis. Hypokalaemia was found in four patients and was mainly due to respiratory alkalosis. However, kaliuria due to hypomagnesaemia contributed to hypokalaemia in 2 patients. Hypomagnesaemia was detected in 3 patients and was attributed to respiratory alkalosis as well as to magnesiuria induced by metabolic acidosis or phosphate depletion. Hypophosphataemia was found in 5 patients who also had respiratory alkalosis and/or phosphaturia due to metabolic acidosis or hypomagnesaemia. Finally, one patient had multifactorial origin hypocalcaemia. CONCLUSION: Febrile patients with bacteraemia develop a number of acid-base and electrolyte disturbances attributed to various pathogenetic mechanisms.
Institution and School/Department of submitter: Πανεπιστήμιο Ιωαννίνων. Σχολή Επιστημών Υγείας. Τμήμα Ιατρικής
Keywords: Acid-Base Imbalance/*etiology,Acidosis/etiology,Adult,Alkalosis/etiology,Bacteremia/*complications,Fever/*etiology,Gram-Negative Bacterial Infections/complications,Humans,Hypocalcemia/etiology,Hypokalemia/etiology,Hypophosphatemia/etiology,Magnesium/blood,Middle Aged,Water-Electrolyte Imbalance/*etiology
URI: https://olympias.lib.uoi.gr/jspui/handle/123456789/24140
ISSN: 1165-0478
Link: http://www.ncbi.nlm.nih.gov/pubmed/8258028
Appears in Collections:Άρθρα σε επιστημονικά περιοδικά ( Ανοικτά)

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