Hypochloraemia and Worse Clinical Outcome in Critically Ill Patients

Gatz, Rainer; Elbers, Paul

doi:https://doi.org/10.1100/2012/234628

The Scientific World Journal

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Clinical Study Letter to the Editor

Letter to the Editor | Open Access

Volume 2012 | Article ID 234628 | https://doi.org/10.1100/2012/234628

Hypochloraemia and Worse Clinical Outcome in Critically Ill Patients

Rainer Gatz¹and Paul Elbers²

Received01 Aug 2012

Accepted30 Aug 2012

Published25 Sept 2012

Tani et al. recently found an association between hypochloraemia and worse clinical outcome in critically ill patients, albeit not as an independent risk factor [1].

The authors were unable to find any explanation for this association. From clinical experience we could invoke three possible causes: use of NaHCO₃, use of loop diuretics, or renal compensation for acidosis, all of which might be more prevalent in sicker patients. One of the tables presents data about the “strong ion gap” (SIG) in the three subgroups of hyper-, normo-, and hypochloraemic patients, with mean values of, respectively, 3.5 versus 4.8 versus 6.2 mEq/L. The corresponding -value is <0.0001. The authors do not mention this in their discussion section, though. While the value of SIG as an independent risk factor for poorer clinical outcome may not be proven, there are a few studies that indicate such a relation [2–6]. The link between hypochloraemia and worse clinical outcome might thus be that hypochloraemia is an indicator of higher SIG values. It would be highly interesting if the authors could contribute to this aspect of their data.

References

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Copyright

Copyright © 2012 Rainer Gatz and Paul Elbers. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

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