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2019, Number 6

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Med Crit 2019; 33 (6)

Standard base deficit clearance as prognostic factor of mortality in septic shock

García GG, Sánchez DJS, Peniche MKG, Monares ZE, Martínez REA, Calyeca SMV

Language: Spanish
References: 36
Page: 298-304
PDF size: 276.77 Kb.


ABSTRACT

Introduction: The concept of base excess (BE) was introduced by Siggaard-Andersen in the late 1950s as a serum marker of strictly metabolic problems. Today the base (B) has been standardized with more effective results when we use the standard base (ecfB) in the clinical evaluation. Lactate and the standard base measured upon admission to the Intensive Care Unit (ICU) are of prognostic utility in critically ill patients. We decided to measure the standard base deficit clearance at 24 hours after admission in patients with septic shock and evaluate its prognostic utility for mortality.
Material and methods: Cohort, retrospective, descriptive, analytical study that included patients with diagnosis of septic shock according to the third international consensus of sepsis and septic shock (sepsis-3) admitted to the ICU in the period from May 2015 to May 2019. Patients were assigned to belong to group ‹ 11% or group ≥ 11% according to their percentage (%) of standard base deficit clearance at 24 hours.
Results: 118 patients who met the inclusion criteria were included. Of the total, 43 patients were assigned to the standard base deficit clearance group ‹ 11% and 75 patients to the standard base deficit clearance group ≥ 11%. In the group with clearance ‹ 11% the mortality was 65.1 and 36% for the group with clearance ≥ 11% with p = ‹ 0.05.
Conclusion: Clearance the standard base deficit ‹ 11% after 24 hours of admission to the ICU increases the risk of death in septic shock. The percentage of standard base deficit clearance is an excellent alternative, since its performance to predict mortality has a prognostic capacity similar to that of lactate.


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