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Metabolic acid-base status in critically ill patients: is standard base excess correlated with serum lactate level?
Danilo Teixeira Noritomi1, Ricardo Reis Sanga, André Carlos Kajdaksi-Balla Amaral1
1Medical Intensive Care Unit, Hospital das Clínicas, Faculdade de Medicina, Universidade de São Paulo, São Paulo, Brazil.
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.
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