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2019, Number 4

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Med Crit 2019; 33 (4)

Lactate clearance as a predictor of death in trauma patients

Martínez GV, Mendoza RM, López GA, Cortés MJA, Mendoza PE

Language: Spanish
References: 15
Page: 170-175
PDF size: 145.60 Kb.


ABSTRACT

Background: Patients with trauma require markers that predict mortality; lactate clearance has not been described in the Mexican population.
Objective: To identify the relationship that exists between the depuration of lactate and the mortality of the patient with trauma in the Intensive Care Unit.
Material and methods: A cross-sectional study was carried out in intensive care unit (ICU) with 80 patients with demographic variables such as trauma, lactate on admission, six, 12, 24, 36 and 48 hours, Lactate clearance (LC) a six, 12, 24, 36 and 48 hours, trauma scales. Outcome: mortality at 48 hours.
Results: Regarding the distribution by sexes, 83.75% male and 16.25% female; age: 35.70 ± 15.51 years; 48-hour mortality of 16.3%; trauma severity index with a score lower than 30 of 59%, between 30 to 40 points of 29% and greater than 40 points of 12%. Lactate on admission 4.16 mmol/ L ± 2.02, Lactate at 6 hours 3.58 mmol/L ± 2.08, Lactate at 12 hours 2.73 mmol/L ± 1.83, Lactate at 24 hours 2.27 mmol/L ± 1.72, Lactate at 36 hours 2.03 mmol/L ± 1.87, Lactate at 48 hours 1.87 mmol/L ± 1.85; CL at six hours 12.50%, CL at 12 hours 34.28%, CL at 24 hours 45.31%, CL at 36 hours 52.07%, CL at 48 hours 55.69%. Initial resuscitation with the use of Hartman type solutions and 0.9% saline solution in 100% of the patients, as well as the use of blood products in 72%; Mortality of 16.3%. The Spearman correlation at 24 hours with mortality reported correlation of 0.308, r2 = 0.067, with p = 0.005, at a 95% confidence interval (CI); Lactate clearance at 36 hours with mortality found a correlation of 0.394, r2 = 0.196, with a p = 0.000, at a 95% CI; lactate depuration at 48 hours and mortality a correlation of 0.356, r2 = 0.143, with a p = 0.001, CI 95%.
Conclusions: Lactate clearance is a reliable measure to predict mortality, showing statistical significance after 24 hours.


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