Lactate and base deficit in trauma: Prognostic value

Abstract

Objectives Clinical case discussion and non-systematic literature review on lactate and base deficit in trauma, its pathophysiology and prognostic value.

Materials and method The case of a polytraumatized patient that underwent major vascular and orthopedic surgery, ICU management and outcomes is discussed with the approval of the Ethics Committee of our Institution. The literature search included Pub Med, Scielo and Bireme.

Results Lactate and base deficit are early follow-up clinical tools in trauma for identifying anaerobic metabolism, in addition to evaluating and changing the resuscitation strategy. This model is applicable to cardiovascular surgery.

Conclusions Both in trauma and cardiovascular surgery, lactate and base deficit are biomarkers that need to be quantified very early and in a serial manner. They are independent predictive factors for mortality in trauma patients in the first 48 h.

Similarly, the base deficit allows for an early staging of patients in shock and for establishing with a high probability the need for blood by-products or mass transfusion.

Further studies are required for normotensive patients.