Advertisement

Is anion gap helpful for assessing cardiovascular risk in cardiac intensive care unit?

  • Takahiro Nakashima
    Correspondence
    Corresponding author at: Department of Emergency Medicine and Michigan Center for Integrative Research in Critical Care, University of Michigan, 1500 E. Medical Center Drive, Ann Arbor, MI 48109, USA.
    Affiliations
    Department of Emergency Medicine, Division of Critical Care, Max Harry Weil Institute for Critical Care Research and Innovation, Ann Arbor, MI, USA
    Search for articles by this author
Published:November 17, 2022DOI:https://doi.org/10.1016/j.ijcard.2022.11.009
      In recent years, there is a growing importance of the cardiac intensive care unit (CICU), which is evolved from the conventional coronary care unit (CCU), due to the increasing complexity of CCU patients. [
      • Kasaoka S.
      Evolved role of the cardiovascular intensive care unit (CICU).
      ,
      • Na S.J.
      • Chung C.R.
      • Jeon K.
      • Park C.M.
      • Suh G.Y.
      • Ahn J.H.
      • et al.
      Association between presence of a cardiac intensivist and mortality in an adult cardiac care unit.
      ,
      • Brusca S.B.
      • Barnett C.
      • Barnhart B.J.
      • Weng W.
      • Morrow D.A.
      • Soble J.S.
      • et al.
      Role of critical care medicine training in the cardiovascular intensive care unit: survey responses from dual certified critical care cardiologists.
      ] Cardiac intensivists are exposed to an increasing amount of non-cardiac organ failures. To date, several scoring methods to stratify the prognosis in critically ill patients, such as sequential organ failure assessment (SOFA) score, acute physiologic and chronic health evaluation (APACHE), and simplified acute physiology score (SAPS), have been developed in the general intensive care unit because early detection of risk factors is beneficial. The SOFA score is a simple scoring system based on six organ failures, which allows us to repeat the evaluation over. [
      • Vincent J.L.
      • de Mendonça A.
      • Cantraine F.
      • Moreno R.
      • Takala J.
      • Suter P.M.
      • et al.
      Use of the SOFA score to assess the incidence of organ dysfunction/failure in intensive care units: results of a multicenter, prospective study. Working group on “sepsis-related problems” of the European Society of Intensive Care Medicine.
      ] However, since cardiovascular failure in the SOFA score is evaluated by blood pressure alone, it may not be applied to patients admitted to the CICU. [
      • Bachmann K.F.
      • Arabi Y.M.
      • Regli A.
      • Starkopf J.
      • Reintam Blaser A.
      Cardiovascular SOFA score may not reflect current practice.
      ]
      To read this article in full you will need to make a payment

      Purchase one-time access:

      Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online access
      One-time access price info
      • For academic or personal research use, select 'Academic and Personal'
      • For corporate R&D use, select 'Corporate R&D Professionals'

      Subscribe:

      Subscribe to International Journal of Cardiology
      Already a print subscriber? Claim online access
      Already an online subscriber? Sign in
      Institutional Access: Sign in to ScienceDirect

      References

        • Kasaoka S.
        Evolved role of the cardiovascular intensive care unit (CICU).
        J. Intensive Care. 2017; 5: 1-5
        • Na S.J.
        • Chung C.R.
        • Jeon K.
        • Park C.M.
        • Suh G.Y.
        • Ahn J.H.
        • et al.
        Association between presence of a cardiac intensivist and mortality in an adult cardiac care unit.
        J. Am. Coll. Cardiol. 2016; 68: 2637-2648
        • Brusca S.B.
        • Barnett C.
        • Barnhart B.J.
        • Weng W.
        • Morrow D.A.
        • Soble J.S.
        • et al.
        Role of critical care medicine training in the cardiovascular intensive care unit: survey responses from dual certified critical care cardiologists.
        J. Am. Heart Assoc. 2019; 8e011721
        • Vincent J.L.
        • de Mendonça A.
        • Cantraine F.
        • Moreno R.
        • Takala J.
        • Suter P.M.
        • et al.
        Use of the SOFA score to assess the incidence of organ dysfunction/failure in intensive care units: results of a multicenter, prospective study. Working group on “sepsis-related problems” of the European Society of Intensive Care Medicine.
        Crit. Care Med. 1998; 26: 1793-1800
        • Bachmann K.F.
        • Arabi Y.M.
        • Regli A.
        • Starkopf J.
        • Reintam Blaser A.
        Cardiovascular SOFA score may not reflect current practice.
        Intensive Care Med. 2022; 48: 119-120
        • Zhao
        • et al.
        Combining the anion gap with the sequential organ failure assessment score to evaluate the short-term prognosis of patients in the cardiac intensive care unit.
        Int. J. Cardiol. 2022;
        • Emmett M.
        • Narins R.G.
        Clinical use of the anion gap.
        Medicine (Baltimore). 1977; 56: 38-54
        • Sahu A.
        • Cooper H.A.
        • Panza J.A.
        The initial anion gap is a predictor of mortality in acute myocardial infarction.
        Coron. Artery Dis. 2006; 17: 409-412
        • Tang Y.
        • Lin W.
        • Zha L.
        • Zeng X.
        • Zeng X.
        • Li G.
        • et al.
        Serum anion gap is associated with all-cause mortality among critically ill patients with congestive heart failure.
        Dis. Markers. 2020; 2020: 8833637
        • Vincent J.L.
        • Quintairos E.S.A.
        • Couto Jr., L.
        • Taccone F.S.
        The value of blood lactate kinetics in critically ill patients: a systematic review.
        Crit. Care. 2016; 20: 257

      Linked Article