Abstract
Acid-base disorders occur when the body's normal pH is out of balance. They can be caused by problems with kidney or respiratory function or by an excess of acids or bases that the body cannot properly eliminate. Acid-base and potassium imbalances are mechanistically linked because acid-base imbalances can alter the transport of potassium. Both acid-base and potassium imbalances are common in critically ill patients. This study investigated machine learning models for predicting the occurrence of acid-base and potassium imbalances in intensive care patients. We used an institutional dataset of 1089 patients with 87 variables, including vital signs, general appearance, and laboratory results. Gradient boosting (GB) was able to predict nine clinical conditions related to acid-base and potassium imbalances: mortality (AUROC = 0.9822), hypocapnia (AUROC = 0.7524), hypercapnia (AUROC = 0.8228), hypokalemia (AUROC = 0.9191), hyperkalemia (AUROC = 0.9565), respiratory acidosis (AUROC = 0.8125), respiratory alkalosis (AUROC = 0.7685), metabolic acidosis (AUROC = 0.8682), and metabolic alkalosis (AUROC = 0.8284). Some predictions remained relatively robust even when the prediction window was increased. Additionally, the decision-making process was made more interpretable and transparent through the use of SHAP analysis. Overall, the results suggest that machine learning could be a useful tool to gain insight into the condition of intensive care patients and assist in the management of acid-base and potassium imbalances.