Serum Lactate and Base Deficit as a Predictor of Morbidity and Mortality In Shock Patients of Trauma and Sepsis in Surgical ICU
Journal Title: International Journal of Medical Research Professionals - Year 2018, Vol 4, Issue 4
Abstract
Objectives: To determine whether lactate levels and base deficits in critically ill surgical intensive care unit (SICU) patients correlate and whether either measure is a significant indicator of mortality and morbidity. Methods: A review was made of 50 SICU patients who had serial lactate and blood gas measurements. Initial and 18th hour lactate and base deficit levels, as well as time to lactate clearence were compared among survivors and non survivors for the entire group. Results: Initial and 24-hour lactate level was significantly elevated in nonsurvivors versus survivors (P = 0.002). Initial base deficit was not significantly different; 24-hour base deficit did achieve statistical significance (P = 0.02). The Middle age group from 21 to 40 yrs form the largest subset of population affected. The prdicted mortality rates by the serial lactate levels at admission, 6th hours, 12 hours, and 18th hour for both trauma and sepsis are 31.81%, 59.09%, 72.72% and 81.81%. There was poor correlation between initial and 24-hour lactate and base deficit among all patients (r = -0.3 and -0.5). Mortality if lactate normalized within 24 hours was 10%, compared with 24% for >48 hours and 67% if lactate failed to normalize. Physical status at discharge was related to initial lactate (P = 0.05), as well as to lactate clearance time (P = 0.01). Conclusions: Elevated initial and 24-hour lactate levels are significantly correlated with mortality and appear to be superior to corresponding base deficit levels. Lactate clearance time may be used to predict mortality and is associated with outcome at discharge. Initial base deficit is a poor predictor of mortality and did not correlate with lactate levels except in trauma and sepsis nonsurvivors. In addition to being used as an endpoint for resuscitation, lactate may be predictive of certain morbidities and patient outcome at discharge.
Authors and Affiliations
Rajiv Verma, Veer Kavita
Keywords
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- EP ID EP535455
- DOI 10.21276/ijmrp.2018.4.4.055
- Views 85
- Downloads 0
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