Serum bicarbonate may replace the arterial base deficit in the trauma intensive care unit

FitzSullivan, Elizabeth; Salim, Ali; Δημητριάδης, Δημήτριος; Asensio, Juan A.; Martin, Matthew J.

doi:10.1016/j.amjsurg.2005.08.024

Cited by 43 publications

(36 citation statements)

References 34 publications

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“…The study population was comparable to recent trauma populations [2,6,7,[19][20][21][22]10,23]. However, in a historic study, hospital admission blood glucose was highly predictive for inhospital mortality, [6] which is, in part, in contrast to the current data.…”

Section: Discussioncontrasting

confidence: 77%

“…As in previous investigations [6,7], admission blood glucose showed only a low correlation, and no co-linearity to other welldocumented factors for outcome and/or injury severity prediction such as lactate, pH, bicarbonate, standard base excess, and haemoglobin (data not shown) [19][20][21][22]. These factors are, at least in part, influenced by the type and amount of fluids being administered pre-hospitally.…”

Section: Discussionmentioning

confidence: 34%

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Admission blood glucose predicted haemorrhagic shock in multiple trauma patients

Kreutziger

Rafetseder

Mathis

et al. 2015

Injury

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Section: Discussioncontrasting

confidence: 77%

Section: Discussionmentioning

confidence: 34%

Admission blood glucose predicted haemorrhagic shock in multiple trauma patients

Kreutziger

Rafetseder

Mathis

et al. 2015

Injury

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“…Other measurements of metabolic acidosis have shown a correlation with mortality [65,66]. The most extensively studied is base deficit.…”

Section: Endpoints For the Resuscitationmentioning

confidence: 99%

“…All patients who corrected the acidosis in the first 24 hours survived. Mortality increased as the time elapsed to normalization was longer [63,64].Other measurements of metabolic acidosis have shown a correlation with mortality [65,66]. The most extensively studied is base deficit.…”

mentioning

confidence: 99%

Critical Care Issues in the Early Management of Severe Trauma

García

2006

Surgical Clinics of North America

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Violent trauma and road traffic injuries kill more than 2.5 million people in the world every year. It has been calculated by the World Health Organization that in 2002 there occurred 1.6 million violent deaths [1] and 1.2 million deaths from traffic injury [2], for a combined mortality of 48 deaths per 100,000 population per year.Most trauma deaths occur at the scene or in the first hour after trauma, with a proportion from 34% to 50% occurring in hospitals [3]. These deaths could be prevented by optimization of trauma care. Preventability of trauma deaths has been reported as high as 76% [4] and as low as 1% in mature trauma systems [5,6].Prehospitalization procedures, elapsed time to hospital arrival are, of course, vital to the whole trauma scenario, but errors made in the in-hospital phase of care are responsible for one third to two thirds of the reported by different authors [7,8]. Of these, intensive care unit (ICU) errors are among the most frequent and significant. Errors in the ICU management of trauma patients were studied by Duke and colleagues [9]. They reported 165 ICU trauma deaths. Two hundred fifty-eight errors occurred in 81 patients (52%), and 134 of them contributed to death in 52 patients (34%). ICU errors were classified as management errors (82%), diagnostic (9%), technique (5%), and system inadequacies (4%). Davis and colleagues [10] identified critical care errors in 30% of 125 trauma deaths with errors. These errors contributed to 48% of all preventable deaths.The most common critical care errors are related to airway and respiratory management, fluid resuscitation, neurotrauma diagnosis and support, and delayed diagnosis of critical lesions [9,10].It is imperative for the general surgeon who takes care of trauma patients to know how to deal with these critical aspects, to reduce preventable morbidity and mortality. In the next segment, the situations in which the participation of the surgeon is crucial, during the initial phases of reanimation and stabilization of the critically traumatized patient will be discussed. Airway and ventilation managementAirway and respiratory management errors are the most common of those identified by several authors [9][10][11] The cardinal manifestation is a sudden or a rapidly progressing desaturation, frequently accompanied by tachycardia and arrhytmias, and occasionally by agitation. Hypertension announces the cardiovascular collapse, and bradicardia appears immediately after the total collapse [12]. The symptoms should not be attributed to agitation when it is present, and other possible causes must be ruled out before. Diagnosing the complication involves a directed physical examination, the analysis of the airway pressures and ventilator volumes, chest radiographs, and sometimes the measurement of arterial blood gases (ABG), and the urinary bladder pressure ( Table 1).The emergency conditions in which the access to the airways must be gained, the displacement to diagnosis areas or operating room and the agitation, often present, make the critical...

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“…En este se destaca el uso del exceso o déficit de base (BE), que representa el número de miliequivalentes adicionales de ácido o base que se deben agregar a un litro de sangre para normalizar el pH a una temperatura de 37 • C y para su cálculo se tiene en cuenta la PaCO 2 y el pH (medidos). Esta variable se divide en BE y BE estándar (SBE), cuya diferencia radica en que la máquina de gases calcula esta última, estimando una concentración de hemoglobina de 5 g/dl en el líquido extracelular 6,24,[27][28][29][30][31][32][33] . El SBE tiene una relación directa con los cambios en la SID y la concentración total de ácidos débiles, es decir, un défi-cit de base (SBE negativo) corresponde a una SID positiva y representa la presencia de aniones no medidos (p.…”

Section: Enfoque De Siggaard-andersenunclassified

Equilibrio ácido-base: el mejor enfoque clínico

Aristizábal-Salazar

Calvo-Torres

Valencia-Arango

et al. 2015

Revista Colombiana de Anestesiología

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Cómo citar este artículo: Aristizábal-Salazar RE, et al. Equilibrio ácido-base: el mejor enfoque clínico. Rev Colomb Anestesiol. 2015. http://dx.información del artículo Historia del artículo: Recibido el 22 de abril de 2014 Aceptado el 18 de abril de 2015 On-line el xxx Palabras clave: Acidosis Alcalosis Colombia Desequilibrio Ácido-Base Anestesia r e s u m e n Las alteraciones del equilibrio ácido-base se pueden presentar en pacientes de forma primaria o secundaria a un proceso patológico como la diabetes mellitus o la falla renal entre otros.El objetivo de este artículo es explicar y orientar la correlación clínica del paciente con los parámetros de los gases arteriales de manera sencilla y precisa, para realizar un diagnóstico de las alteraciones del equilibrio ácido-base correcto, que permita efectuar intervenciones terapéuticas adecuadas y oportunas. Se realizó una revisión no sistemática de la literatura científica en la cual se consultaron las siguientes bases de datos: PubMed, ScienceDirect, Scopus y OvidSP en busca de artículos relevantes. Se concluyó que el exceso o déficit de base es una herramienta útil de los gases arteriales, que aunada a la historia clínica, el pH y la presión parcial de CO 2 estima de forma muy precisa el componente metabólico del equilibrio ácido-base.

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Serum bicarbonate may replace the arterial base deficit in the trauma intensive care unit

Cited by 43 publications

References 34 publications

Admission blood glucose predicted haemorrhagic shock in multiple trauma patients

Admission blood glucose predicted haemorrhagic shock in multiple trauma patients

Critical Care Issues in the Early Management of Severe Trauma

Equilibrio ácido-base: el mejor enfoque clínico

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