tailieunhanh - Báo cáo y học: "Severe hyperlactatemia with normal base excess: a quantitative analysis using conventional and Stewart approaches."

Tuyển tập các báo cáo nghiên cứu về y học được đăng trên tạp chí y học Critical Care giúp cho các bạn có thêm kiến thức về ngành y học đề tài: Severe hyperlactatemia with normal base excess: a quantitative analysis using conventional and Stewart approaches. | Available online http content 1 2 3 R66 Research Severe hyperlactatemia with normal base excess a quantitative analysis using conventional and Stewart approaches Graciela Tuhay María Carolina Pein Fabio Daniel Masevicius Daniela Olmos Kutscherauer and Arnaldo Dubin Servicio de Terapia Intensiva Sanatorio Otamendi y Miroli Buenos Aires Argentina Corresponding author Arnaldo Dubin arnaldodubin@ Received 10 Mar 2008 Revisions requested 8 Apr 2008 Revisions received 28 Apr 2008 Accepted 8 May 2008 Published 8 May 2008 Critical Care 2008 12 R66 doi cc6896 This article is online at http content 12 3 R66 2008 Tuhay et al. licensee BioMed Central Ltd. This is an open access article distributed under the terms of the Creative Commons Attribution License http licenses by which permits unrestricted use distribution and reproduction in any medium provided the original work is properly cited. Open Access Abstract Introduction Critically ill patients might present complex acidbase disorders even when the pH PCO2 HCO3- and base excess BE levels are normal. Our hypothesis was that the acidifying effect of severe hyperlactatemia is frequently masked by alkalinizing processes that normalize the BE . The goal of the present study was therefore to quantify these disorders using both Stewart and conventional approaches. Methods A total of 1 592 consecutive patients were prospectively evaluated on intensive care unit admission. Patients with severe hyperlactatemia lactate level mmol l were grouped according to low or normal BE values -3 mmol l or -3 mmol l . Results Severe hyperlactatemia was present in 168 of the patients 11 . One hundred and thirty-four 80 patients had low BE levels while 34 20 patients did not. Shock was more frequently present in the low BE group 46 versus 24 P and chronic obstructive pulmonary disease in the normal BE group 38 versus 4 P . Levels of lactate were slightly higher in