Can venous base excess replace arterial base excess as a marker of early shock and a predictor of survival in trauma?

Wijaya, Ramesh; Ng, Jia Hui; Ong, Lester Wei Lin; Wong, Andrew Siang Yih

doi:10.11622/smedj.2016031

Cited by 9 publications

(7 citation statements)

References 23 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“… 22 ) have shown satisfactory agreement between resting arterial and venous blood pH, PCO 2 and Base Excess, especially for subjects who are not in shock, as in this study. This agreement is confirmed in another study that included trauma patients 23 , but has not been demonstrated with mechanically ventilated patients 24 . As the PO 2 is expected to diverge significantly in arterial and venous samples, this variable was not included in this study and was replaced by arterial O 2 saturation.…”

Section: Discussionmentioning

confidence: 61%

Lack of acclimatization to chronic hypoxia in humans in the Antarctica

Porcelli

Marzorati

Healey

et al. 2017

Sci Rep

View full text Add to dashboard Cite

The study was carried out at Concordia Station (Antarctic Plateau). The aim was to investigate the respiratory and haematological responses to hypoxia in healthy subjects living at constant altitude. Thirteen men and women (34.1 ± 3.1 years) were exposed for 10 months to hypobaric hypoxia (oxygen level equivalent to 3800 m asl). These unique conditions enable a greater accuracy of monitoring human responses to chronic hypoxia than can be achieved elsewhere. Blood haemoglobin and erythropoietin concentrations were determined at sea level (Pre), and after 3, 7, 20, 90 and 300 days at altitude. Blood gas analysis, base excess and arterial oxygen saturation were measured at Pre, and after 150 and 300 days at altitude. Erythropoietin returned quickly to baseline level after a transient increase in the first days. Blood haemoglobin concentration started increasing at day 7 and remained markedly higher for the entire duration of the mission. At day 150 the blood carbon dioxide partial pressure was markedly reduced, and consequently blood pH remained higher at negative base excess until day 300. The arterial oxygen saturation remained lower than Pre throughout. In conclusion, humans display little capacity of hypoxia acclimatization even after ten months of constant exposure to low oxygen partial pressure.

show abstract

Section: Discussionmentioning

confidence: 61%

Lack of acclimatization to chronic hypoxia in humans in the Antarctica

Porcelli

Marzorati

Healey

et al. 2017

Sci Rep

View full text Add to dashboard Cite

show abstract

“…Patients with a base deficit C3 meq/L at admission had an 11-time greater risk at dying compared to patients with a base deficit of \3 meq/L. A base deficit provides a fast estimate of the physiological disturbance of the patient, is a marker for shock and is usually part of the standard diagnostic armamentarium in the emergency department [31,32]. Base deficits are already used to predict complications and mortality in trauma and intensive care patients and has been described by Elliot et al to also predict mortality in NSTI patients [31][32][33][34].…”

Section: Discussionmentioning

confidence: 99%

“…A base deficit provides a fast estimate of the physiological disturbance of the patient, is a marker for shock and is usually part of the standard diagnostic armamentarium in the emergency department [31,32]. Base deficits are already used to predict complications and mortality in trauma and intensive care patients and has been described by Elliot et al to also predict mortality in NSTI patients [31][32][33][34]. It has been suggested that the LRINEC score might also be predictive for mortality, since this score also looks at markers for sepsis severity in NSTI patients; however, in this study the LRINEC score was not predictive for mortality and was in most patients far below the cutoff point for NSTI suspicion [13,35].…”

Section: Discussionmentioning

confidence: 99%

Factors Associated with Mortality and Amputation Caused by Necrotizing Soft Tissue Infections of the Upper Extremity: A Retrospective Cohort Study

et al. 2019

View full text Add to dashboard Cite

Background It is unclear what the exact short-term outcomes of necrotizing soft tissue infections (NSTIs), also known and necrotizing fasciitis of the upper extremity, are and whether these are comparable to other anatomical regions. Therefore, the aim of this study is to assess factors associated with mortality within 30-days and amputation in patients with upper extremity NSTIs. Methods A retrospective study over a 20-year time period of all patients treated for NSTIs of the upper extremity was carried out. The primary outcomes were the 30-day mortality rate and the amputation rate in patients admitted to the hospital for upper extremity NSTIs. Results Within 20 years, 122 patients with NSTIs of the upper extremity were identified. Thirteen patients (11%) died and 17 patients (14%) underwent amputation. Independent risk factors for mortality were an American Society of Anesthesiologists (ASA) classification of 3 or higher (OR 9.26, 95% CI 1.64-52.31) and a base deficit of 3 meq/L or greater (OR 10.53, 95% CI 1.14-96.98). The independent risk factor for amputation was a NSTI of the nondominant arm (OR 3.78, 95% CI 1.07-13.35). Length of hospital stay was 15 (IQR 9-21) days. Conclusion Upper extremity NSTIs have a relatively low mortality rate, but a relatively high amputation rate compared to studies assessing NSTIs of all anatomical regions. ASA classification and base deficit at admission predict the prognosis of patients with upper extremity NSTIs, while a NSTI of the non-dominant side is a risk factor for limb loss.

show abstract

“…However, it is not possible to measure this parameter in all trauma centers. On the other hand, BE of the blood is an index of shock and physiological impairment in trauma patients and is associated with blood lactate concentration and the severity of the injury [ 16 , 17 ]. Factors that affect the base deficit include the use of bicarbonate, hypothermia, hypocapnia, heparin, ethanol and ketoacidosis [ 18 , 19 ].…”

Section: Introductionmentioning

confidence: 99%

Prognostic Value of Arterial Blood Gas Indices Regarding the Severity of Traumatic Injury and Fractures of the Femur and Pelvis

Mohsenian

Khoramian

Mazloom

2018

BEAT

View full text Add to dashboard Cite

Objective:To evaluate the prognostic value of arterial blood gas (ABG) indices, especially base excess (BE), regarding the severity of traumatic injury.Methods:A total number of 96 trauma patients with fractures of femur and pelvis were included in this study. Demographic characteristics and clinical information of samples were recorded. The results of ABG test and hemoglobin (Hb) were evaluated at two time intervals (on admission and 6 hours later). The outcome of the patients was evaluated at the end of the study (dead or alive). The ABG indices included O2 saturation (O2Sat), PH, PO2, PCO2, bicarbonate (HCO3) and base excess (BE). The mean of the hemodynamic and ABG indices were compared between those who were discharged and mortality cases. The confounders were compensated using a multivariate logistic regression model. Results:Overall 94 trauma patients with long and pelvic fractures were included. There were 69 (73.4%) men and 25 (26.6%) women among the patients with mean age of 37.43 ± 20.07 years. The mortality rate was 10 (10.6%). The most common mechanism of injury was motorcycle accident in 41 (43.6%) and car collision in 43 (45.7%) patients. We found that mortality was significantly associated with amount of FFP transfusion (p=0.005), but was not associated with amount of transfused packed cells (p=0.113). We also found that mortality was associated with lower BP after 6 hours of admission (p=0.001), higher HR on admission (p=0.036), lower HR after 6 hours (p=0.017), lower O2Sat on admission (p<0.001), higher PCO2 after 6 hours and lower BE on admission (p=0.025). Conclusion: The ABG indices including O2Sat, BE and PCO2 are considered prognostic determinants of outcome in trauma patients with long and pelvic fractures. These findings can be considered as fundamental studies to achieve new diagnostic methods.

show abstract

Can venous base excess replace arterial base excess as a marker of early shock and a predictor of survival in trauma?

Cited by 9 publications

References 23 publications

Lack of acclimatization to chronic hypoxia in humans in the Antarctica

Lack of acclimatization to chronic hypoxia in humans in the Antarctica

Factors Associated with Mortality and Amputation Caused by Necrotizing Soft Tissue Infections of the Upper Extremity: A Retrospective Cohort Study

Prognostic Value of Arterial Blood Gas Indices Regarding the Severity of Traumatic Injury and Fractures of the Femur and Pelvis

Contact Info

Product

Resources

About