碱缺失优于乳酸在创伤中的应用。
Base deficit is superior to lactate in trauma.
机构信息
UCSF Fresno Department of Surgery, Department of Surgery 1st Floor, 2823 Fresno St., Fresno, CA 93721, USA.
出版信息
Am J Surg. 2018 Apr;215(4):682-685. doi: 10.1016/j.amjsurg.2018.01.025. Epub 2018 Jan 31.
BACKGROUND
Base Deficit (BD) and lactate have been used as indicators of shock and resuscitation. This study was done to determine the association of BD and lactate and to determine if one is superior.
METHODS
A retrospective review from 3/2014-12/2016 was performed. Data included demographics, systolic BP, ISS, BD, lactate, blood transfusion, and outcomes. BD and lactate were modeled continuously and categorically and compared.
RESULTS
1191 patients were included. BD and lactate correlated strongly (r = -0.76 p < 0.001). Higher lactate and more negative BD were associated with transfusion and mortality. On multivariate regression, only BD was associated with transfusion (OR = 0.8, p < 0.001). As a categorical variable, worsening BD was associated with decreased BP, higher ISS, increased transfusions and worse outcomes.
CONCLUSIONS
BD and lactate are strongly related. BD was superior to lactate in assessing the need for transfusion. The BD categories discriminate high risk trauma patients better than lactate.
背景
基础赤字（BD）和乳酸已被用作休克和复苏的指标。本研究旨在确定 BD 和乳酸的相关性，并确定哪一个更优。
方法
对 2014 年 3 月至 2016 年 12 月的回顾性研究进行了回顾。数据包括人口统计学、收缩压、ISS、BD、乳酸、输血和结局。对 BD 和乳酸进行了连续和分类建模，并进行了比较。
结果
共纳入 1191 例患者。BD 和乳酸相关性强（r=-0.76，p<0.001）。乳酸水平升高和 BD 负值越大，与输血和死亡率相关。多变量回归分析显示，只有 BD 与输血相关（OR=0.8，p<0.001）。作为分类变量，BD 恶化与血压降低、ISS 升高、输血增加和结局恶化相关。
结论
BD 和乳酸相关性强。BD 在评估输血需求方面优于乳酸。BD 分类比乳酸更能区分高危创伤患者。
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