Base deficit, lactate clearance, and shock index as predictors of morbidity and mortality in multiple-trauma patients

• Published in: Colombian journal of anesthesiology (Inglâes) 2018-09, Vol.46 (3), p.208-215
• Main Authors: Cortés-Samacá, Carlos Andrés, Meléndez-Flórez, Héctor Julio, Robles, Saúl Álvarez, Meléndez-Gómez, Eduardo Andrés, Puche-Cogollo, Carla Andrea, Mayorga-Anaya, Henry Jair
• Format: Article
• Language: English
• Subjects: ANESTHESIOLOGY
• ISSN: 2256-2087; 0120-3347
• DOI: 10.1097/CJ9.0000000000000064

Abstract Introduction: Physiological responses to hemorrhage are not proportional to blood loss. This has led to the use of scores such as the shock index (SI) or biomarkers such as lactate clearance (LC) and base deficit (BD) in the assessment of multiple trauma patients. Objective: To determine the risk between no LC, persistence of BD, and severe SI at 6 hours, and postoperative morbidity and mortality. Methods: Prospective cohort study with multiple trauma patients taken to surgery. SI, BD, and lactate levels were calculated on admission and after 6hours; LC was estimated at 6 hours; and follow-up was performed after 28 days to determine morbidity and mortality. Inadequate LC was defined as 1, and abnormal BD as 45 years, suture dehiscence, transfusions. Conclusion: In multiple trauma patients in shock, low LC, severe SI, and persistent BD at 6 hours were significant for morbidity and mortality and their use as follow-up markers should be encouraged in resuscitation therapies for patients in shock.