Metabolic acid-base status in critically ill patients: is standard base excess correlated with serum lactate level?

Revista Brasileira de Terapia Intensiva

Danilo Teixeira Noritomi²  Ricardo Reis Sanga¹  André Carlos Kajdaksi-balla Amaral²  Marcelo Park² 

[1] ,Universidade de São Paulo Faculdade de Medicina Hospital das ClínicasSão Paulo,Brazil

关键词: Acid-base equilibrium;    acidosis;    critical illness;    lactic acid;    prognosis;    Acidose láctica;    acidose metabólica;    doença crítica;    equilíbrio ácido básico;    prognóstico;   

DOI  :  10.1590/S0103-507X2006000100005

来源: SciELO

【 摘 要 】

BACKGROUND AND OBJECTIVES: To correlate standard base excess (SBE) with serum lactate level and demonstrate the independent prognostic significance of each one. METHODS: In a retrospective study, we retrieved data from 333 patients of our prospectively collected database of 7-bed medical intensive care unit of a 1800-bed university hospital. RESULTS: The results have shown a poor correlation between SBE and lactate, r = - 0.358, p < 0.001, and an independent prognostic significance of each one when analyzed concomitantly, odds ratio (95% Confidence interval) = 0.996 (0.992 - 0.999) to standard base excess and 1.000 (1.000 - 1.002) to lactate at entrance; and odds ratio (95% Confidence interval ) = 0.990 (0.985 - 0.994) to standard base excess and 1.003 (1.001 - 1.005) to lactate after 24 hours. The accuracy of standard base excess was close to lactate to determine in-intensive care unit death. CONCLUSIONS: The lactic component of the metabolic acidosis is not the major determinant of standard base excess. Serum lactate and SBE are independent outcome predictors in critically ill patients.

【 授权许可】

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