Kaups K L, Davis J W, Dominic W J
Department of Surgery, UCSF/Fresno, University Medical Center, USA.
J Burn Care Rehabil. 1998 Jul-Aug;19(4):346-8. doi: 10.1097/00004630-199807000-00013.
The utility of base deficit (BD) as a marker of shock and as an indicator of resuscitation requirements has been recognized in the trauma population. Base deficit in thermally injured patients has not been closely examined. The purpose of this study was to evaluate the usefulness of initial BD related to other resuscitation parameters in thermally injured patients. Burn center records over a 2-year period were reviewed; patients who survived at least 24 hours and had initial arterial blood gases were included. Parkland estimated fluid requirements underestimated actual volume requirements, but Parkland-calculated fluid requirements were related (p < 0.01) to actual volume requirements. BD had a better correlation to actual volume requirements, and a BD of -6 or less correlated with larger burn size (23% +/- 2% vs 47% +/- 9% total body surface area), and markedly increased mortality rate (9% vs 72%, p < 0.001).
碱缺失(BD)作为休克的标志物以及复苏需求指标在创伤人群中的作用已得到认可。但热损伤患者的碱缺失情况尚未得到深入研究。本研究旨在评估热损伤患者初始碱缺失与其他复苏参数相关的实用性。回顾了2年期间烧伤中心的记录;纳入至少存活24小时且有初始动脉血气的患者。帕克兰公式估算的液体需求量低于实际需求量,但帕克兰公式计算的液体需求量与实际需求量相关(p < 0.01)。碱缺失与实际液体需求量的相关性更好,碱缺失≤ -6与更大的烧伤面积相关(23% ± 2%对47% ± 9%体表面积),且死亡率显著升高(9%对72%,p < 0.001)。