Discussion
It is well known that various ABD are very common
in critical illness. Prompt correction of ABD and
treatment of the underlying causes as soon as possible
is the key to reduce morbidity and mortality. However,
the prevalence of ABD among emergency cases is
seldom reported. Our findings have shown that the
incidence of ABD in emergency room is very high
(97.3%) and was comparable to previously reported
figures (94.2%-96.8%).8,9 It suggests that we should
pay more attention to the diagnosis and management
of ABD for critical patients.
We took arterial and venous blood samples
simultaneously from all patients in order to measured
blood gas analyses and serum electrolytes (Na+, K+ and
Cl−). The aim was to calculate AG and potential
bicarbonate. In general, AG helps us diagnose
metabolic acidosis while potential bicarbonate helps
diagnose metabolic alkalosis. Both of them help us
diagnose TABD. In our study, before calculating AG,
the number of patients with metabolic acidosis was
assumed to be 538 cases (72.2%). However, after
calculating AG, it increased to 678 (91%). Before AG
was calculated, only 12 patients (1.6%) with TABD
were in metabolic acidosis. However, after calculation,
the number increased to 71 (9.5%). It indicated that
59 cases (83.1%) of TABD would have been missed if
AG was not calculated. Meanwhile AG also influences