Venous and arterial base deficits

Zakrison, Tanya L.; McFarlan, Amanda; Wu, Yan Yan; Keshet, Itay; Nathens, Avery B.

doi:10.1097/ta.0b013e318282747a

Cited by 9 publications

(6 citation statements)

References 21 publications

(23 reference statements)

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“…These modifications were deemed negligible and the authors concluded that the techniques were equivalent. Very good agreement between arterial and venous measurements of base deficit was also found in trauma patients [9, 10]. Similar results, with a mean pH difference of 0.03 [95% CI − 0.02 to 0.08], were found in critically ill patients with metabolic acidosis of various causes, except ketoacidosis [11].…”

Section: Areas Of Recommendationssupporting

confidence: 58%

Diagnosis and management of metabolic acidosis: guidelines from a French expert panel

Jung¹,

Martinez²,

Claessens³

et al. 2019

Ann. Intensive Care

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Metabolic acidosis is a disorder frequently encountered in emergency medicine and intensive care medicine. As literature has been enriched with new data concerning the management of metabolic acidosis, the French Intensive Care Society (Société de Réanimation de Langue Française [SRLF]) and the French Emergency Medicine Society (Société Française de Médecine d’Urgence [SFMU]) have developed formalized recommendations from experts using the GRADE methodology. The fields of diagnostic strategy, patient assessment, and referral and therapeutic management were addressed and 29 recommendations were made: 4 recommendations were strong (Grade 1), 10 were weak (Grade 2), and 15 were experts’ opinions. A strong agreement from voting participants was obtained for all recommendations. The application of Henderson–Hasselbalch and Stewart methods for the diagnosis of the metabolic acidosis mechanism is discussed and a diagnostic algorithm is proposed. The use of ketosis and venous and capillary lactatemia is also treated. The value of pH, lactatemia, and its kinetics for the referral of patients in pre-hospital and emergency departments is considered. Finally, the modalities of insulin therapy during diabetic ketoacidosis, the indications for sodium bicarbonate infusion and extra-renal purification as well as the modalities of mechanical ventilation during severe metabolic acidosis are addressed in therapeutic management.

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Section: Areas Of Recommendationssupporting

confidence: 58%

Diagnosis and management of metabolic acidosis: guidelines from a French expert panel

Jung¹,

Martinez²,

Claessens³

et al. 2019

Ann. Intensive Care

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“…Second, the validation based on blood gas parameters and lactate level taken from arterial or venous blood was not evidence based. According to the result of recent articles [28–30, 36] venous and arterial pH and bicarbonate agree reasonably well at all values and the lactate level showed a poorer agreement only at abnormal values. This was the scientific background using arterial or venous samples.…”

Section: Discussionmentioning

confidence: 77%

“…This parameter combination has never been used previously, but as individual parameters they have an important role to play in the evaluation of the patient’s status. The pH and BE values from the blood gas sample and the lactate levels are strongly related in both arterial and venous blood so we can use samples from either origin [28–30]. These three parameters represent a summary of the pathophysiological processes and are independent of our examined categories.…”

Section: Discussionmentioning

confidence: 99%

Estimation of the severity of breathlessness in the emergency department: a dyspnea score

et al. 2016

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BackgroundDyspnea is a frequent complaint in emergency departments (ED). It has a significant amount of subjective and affective components, therefore the dyspnea scores, based on the patients’ rating, can be ambiguous. Our purpose was to develop and validate a simple scoring system to evaluate the severity of dyspnea in emergency care, based on objectively measured parameters.MethodsWe performed a double center, prospective, observational study including 350 patients who were admitted in EDs with dyspnea. We evaluated the patients’ subjective feeling about dyspnea and applied our Dyspnea Severity Score (DSS), rating the dyspnea in 7 Dimensions from 0 to 3 points. The DSS was validated using the deterioration of pH, base-excess and lactate levels in the blood gas samples (Objective Classification Scale (OCS) 9 points and 13 points groups).ResultsAll of the Dimensions correlated closely with the OCS values and with the subjective feeling of the dyspnea. Using multiple linear regression analysis we were able to decrease the numbers of Dimensions from seven to four without causing a significant change in the determination coefficient in any OCS groups. This reduced DSS values (exercise tolerance, cooperation, cyanosis, SpO2 value) showed high sensitivity and specificity to predict the values of OCS groups (the ranges: AUC 0.77–0.99, sensitivity 65–100%, specificity 64–99%). There was a close correlation between the subjective dyspnea scores and the OCS point values (p < 0.001), though the scatter was very large.ConclusionsA new DSS was validated which score is suitable to compare the severity of dyspnea among different patients and different illnesses. The simplified version of the score (its value ≥7 points without correction factors) can be useful at the triage or in pre-hospital care.

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“…Approximately 80% of victims trapped in disasters die immediately due to serious injuries, while 10% suffer minor trauma and another 10% suffer crush injuries. [4][5][6]15] MacKenzie et al [16] conducted a study revealing that 87% of the injuries requiring medical attention following an earthquake were orthopedic injuries. Furthermore, their research indicated that the incidence of rhabdomyolysis in critically ill patients was found to be 36.2%.…”

Section: Discussionmentioning

confidence: 99%

The impact of creatine kinase and base excess on the clinical outcome of crush injuries sustained during the Kahramanmaras/Turkey earthquakes on February 6, 2023

Gur,

Simsek

2024

Medicine

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The aim of the study is to determine the usefulness of base excess (BE) and creatine kinase (CK) in predicting the extent of damage to the extremities, the need for hemodialysis, and the likelihood of mortality in crush injuries. Our study included patients who were affected by the earthquakes that occurred in Kahramanmaras/Turkey on February 6, 2023 and were diagnosed with crush injuries. The study was a retrospective observational study. We used chi-square test, independent sample t test, analysis of variance (ANOVA) to examine whether CK and BE values can be used to predict damage to the extremities, hemodialysis requirement, and mortality. A total of 299 patients were included in the study. A statistically significant relationship was found between BE and extremity damage, hemodialysis requirement, and mortality (P < .005). A statistically significant difference was also seen in terms of extremity damage and hemodialysis requirement with CK (P < .001), while there was no statistically significant difference seen in mortality (P = .204). BE may serve as a predictive biomarker for the development of extremities damage, hemodialysis requirement, and mortality. CK is not predictive of mortality.

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Venous and arterial base deficits

Abstract: Diagnostic study, level III.

Cited by 9 publications

References 21 publications

Diagnosis and management of metabolic acidosis: guidelines from a French expert panel

Diagnosis and management of metabolic acidosis: guidelines from a French expert panel

Estimation of the severity of breathlessness in the emergency department: a dyspnea score

The impact of creatine kinase and base excess on the clinical outcome of crush injuries sustained during the Kahramanmaras/Turkey earthquakes on February 6, 2023

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