Serum Lactate and Base Deficit: Early Predictors of Morbidity and Mortality in Burn Patients with Inhalation Injury.
10.4174/jkss.2011.80.2.84
- Author:
Yong Suk CHO
1
;
Hyeong Tae YANG
;
Haejun YIM
;
Dohern KIM
;
Jun HUR
;
Jong Hyun KIM
;
Wook CHUN
Author Information
1. Department of Burn Surgery, Burn Center, Hangang Sacred Heart Hospital, College of Medicine, Hallym University, Seoul, Korea. dohern@hallym.ac.kr
- Publication Type:Original Article
- Keywords:
Burn;
Plasma lactate (PL);
Base deficit (BD)
- MeSH:
Bronchoscopy;
Burns;
Burns, Inhalation;
Debridement;
Humans;
Inhalation;
Intensive Care Units;
Lactic Acid;
Nutritional Support;
Pain Management;
Plasma;
Prognosis;
Resuscitation;
Retrospective Studies;
Shock;
Survivors
- From:Journal of the Korean Surgical Society
2011;80(2):84-89
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
PURPOSE: The aim of this study was to elucidate whether plasma lactate (PL) and base deficit (BD) are useful early parameters to predict the prognosis of burn patients with inhalation injury. In addition, one of the main objectives was to evaluate if PL and its change, BD and its change due to fluid resuscitation, adds additional information. METHODS: A retrospective review was performed on 151 patients admitted to our burn intensive care unit who were suspected to have inhalation burn injury, and then were confirmed by fibreoptic bronchoscopy between 1 Jan 2008 and 31 Dec 2008. All patients received proper fluid and electrolyte resuscitation, pain management, nutritional support, wound care and surgical debridement of dead tissue by burn surgeon. RESULTS: Initial PL, PL1 (24 hours later) and initial BD show statistical differences between survivors group and non-survivors group. A better chance of survival occurs when resuscitation results in normal PL values within 24 h. Moreover, an outcome predictor of shock and effective resuscitation could be defined by evaluating the changes of BD on Day 1. Normalization of the BD within 24 h is associated with a better chance of survival. CONCLUSION: Measuring PL, BD and their changes may help to identify burn patients either for adequacy of treatment, or selection of other therapeutic options. Therefore titration of burn resuscitation to normalize PL and BD levels may be a reasonable method to improve burn mortality.
