{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,3]],"date-time":"2026-11-03T17:42:18Z","timestamp":1793727738311,"version":"4.6.1"},"reference-count":35,"publisher":"SAGE Publications","issue":"7","license":[{"start":{"date-parts":[[2025,11,28]],"date-time":"2025-11-28T00:00:00Z","timestamp":1764288000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["J Intensive Care Med"],"published-print":{"date-parts":[[2026,7]]},"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>There is limited evidence on the epidemiology and prognostic significance of acid-base disorders in the cardiovascular intensive care unit (CICU). This study examines the association of acid-base status at admission with in-hospital mortality among CICU patients.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      We conducted a retrospective analysis of adults admitted to the Mayo Clinic CICU from 2007-2018 with available blood gas data, utilizing values obtained closest to CICU admission. Arterial pH, serum bicarbonate, base excess, and partial pressure of carbon dioxide (PaCO\n                      <jats:sub>2<\/jats:sub>\n                      ) were examined as predictors of in-hospital mortality. Multivariable logistic regression was used to assess associations, with adjustment for demographics, comorbidities, illness severity, and interventions.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Among 3229 patients included for analysis, acidemia (pH\u2009&lt;\u20097.35) emerged as the strongest predictor of in-hospital mortality (adjusted odds ratio [aOR] 1.60, 95% confidence interval [CI] 1.29-1.98,\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      \u2009&lt;\u2009.003). Metabolic acidosis (HCO3\u2009&lt;\u200920\u2005mEq\/L, aOR 1.55, 95% CI 1.24-1.95,\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      \u2009&lt;\u2009.001) and respiratory acidosis (PaCO2\u2009&gt;\u200945\u2005mm\u2005Hg, aOR 1.44, 95% CI 1.14-1.81,\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      \u2009=\u2009.002) were associated with higher in-hospital mortality, whereas metabolic and respiratory alkalosis were not. After adjustment, lower pH and more negative base excess were associated with higher in-hospital mortality (both\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      \u2009&lt;\u2009.001), whereas HCO3 and PaCO2 were not (\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      \u2009=\u2009.053 and\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      \u2009=\u2009.051, respectively). Patients with combined metabolic and respiratory acidosis had the highest in-hospital mortality (56.3%).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Short-term survival in CICU patients decreases progressively with worse acidemia, especially in the context of combined metabolic and respiratory acidosis. Incorporating metabolic acid-base disorders as key therapeutic targets in randomized cardiogenic shock trials may improve outcomes in this complex population by addressing hemometabolic shock.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/08850666251399182","type":"journal-article","created":{"date-parts":[[2025,11,28]],"date-time":"2025-11-28T15:48:21Z","timestamp":1764344901000},"page":"670-682","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":3,"title":["Admission Acid-Base Status and Mortality in Cardiac Intensive Care Unit Patients"],"prefix":"10.1177","volume":"41","author":[{"given":"Tyler J.","family":"Canova","sequence":"first","affiliation":[{"name":"Mayo Clinic"},{"name":"Department of Internal Medicine, Mayo Clinic, Rochester, MN, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kirsten","family":"Lipps","sequence":"additional","affiliation":[{"name":"Mayo Clinic"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Garima","family":"Dahiya","sequence":"additional","affiliation":[{"name":"Mayo Clinic"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dustin B.","family":"Hillerson","sequence":"additional","affiliation":[{"name":"Mayo Clinic"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kianoush B.","family":"Kashani","sequence":"additional","affiliation":[{"name":"Mayo Clinic"},{"name":"Division of Pulmonary and Critical Care Medicine, Department of Medicine, Mayo Clinic, Rochester, MN, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6366-2859","authenticated-orcid":false,"given":"Jacob C.","family":"Jentzer","sequence":"additional","affiliation":[{"name":"Mayo Clinic"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2025,11,28]]},"reference":[{"key":"e_1_3_2_2_2","doi-asserted-by":"publisher","DOI":"10.1161\/JAHA.121.024932"},{"key":"e_1_3_2_3_2","doi-asserted-by":"publisher","DOI":"10.1097\/SHK.0000000000001812"},{"key":"e_1_3_2_4_2","doi-asserted-by":"publisher","DOI":"10.1186\/cc10487"},{"key":"e_1_3_2_5_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jcrc.2021.02.006"},{"key":"e_1_3_2_6_2","doi-asserted-by":"publisher","DOI":"10.1097\/SHK.0000000000001582"},{"key":"e_1_3_2_7_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.ahj.2019.05.012"},{"key":"e_1_3_2_8_2","doi-asserted-by":"publisher","DOI":"10.1097\/SHK.0000000000002292"},{"key":"e_1_3_2_9_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.mayocp.2021.01.031"},{"key":"e_1_3_2_10_2","doi-asserted-by":"publisher","DOI":"10.1161\/JAHA.119.013675"},{"key":"e_1_3_2_11_2","doi-asserted-by":"publisher","DOI":"10.1161\/JAHA.117.008169"},{"key":"e_1_3_2_12_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jcrc.2018.12.012"},{"key":"e_1_3_2_13_2","doi-asserted-by":"publisher","DOI":"10.1093\/ehjacc\/zuac012"},{"key":"e_1_3_2_14_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.ahj.2020.02.018"},{"key":"e_1_3_2_15_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1906759"},{"key":"e_1_3_2_16_2","doi-asserted-by":"publisher","DOI":"10.1177\/0885066620982905"},{"key":"e_1_3_2_17_2","doi-asserted-by":"publisher","DOI":"10.1001\/jamacardio.2019.2467"},{"key":"e_1_3_2_18_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.amjmed.2020.09.035"},{"key":"e_1_3_2_19_2","doi-asserted-by":"publisher","DOI":"10.3109\/17482941.2013.776691"},{"key":"e_1_3_2_20_2","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0205309"},{"key":"e_1_3_2_21_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.amjsurg.2018.01.025"},{"key":"e_1_3_2_22_2","doi-asserted-by":"publisher","DOI":"10.1186\/s13054-015-0896-7"},{"issue":"3","key":"e_1_3_2_23_2","article-title":"Bicarbonate therapy for critically ill patients with metabolic acidosis: A systematic review","volume":"11","author":"Ghauri SK","year":"2019","unstructured":"Ghauri SK, Javaeed A, Mustafa KJ, Podlasek A, Khan AS. 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