Alireza Sedaghat; Benyamin Fazli; arash peivandi; Farzaneh Fazeli; Bita Mirzaie Feyzabadi
Abstract
Background and Aim: This study was aimed to evaluate the prognosis of patients with severe burns by measuring the plasma base excess and serum lactate levels and comparing it with the ABSI scoring system as an important indicator in the resuscitation of burn patients.Methods: This prospective cohort ...
Read More
Background and Aim: This study was aimed to evaluate the prognosis of patients with severe burns by measuring the plasma base excess and serum lactate levels and comparing it with the ABSI scoring system as an important indicator in the resuscitation of burn patients.Methods: This prospective cohort study was performed on all patients hospitalized in the burn ward of the hospital. The demographic data and ABSI scoring of all patients were recorded. Patients' clinical information and routine tests, gasometry (for measuring plasma base excess) and serum lactate levels were measured at the time of admission, 12 hours, and 24 hours after admission.Results: A total of 311 burning patients were evaluated in this study. Mann-Whitney test showed a significant difference in the mean plasma BE1 (at the time of admission) and BE2 (24 hours after admission) between the patients who were discharged and the patients who died (P <0.001). The results indicated a difference in the process of lactate changes between two groups of patients in terms of intensity of ABSI(P <0.001). The multivariate logistic regression with the entry of BE and lactate at the time of admission and ABSI as predictive variables indicated a significant BE and ABSI.Conclusion: The results of this study confirmed that the plasma base excess can be used as a valuable tool in the monitoring of burn patients' resuscitation along with clinical criteria. On the other hand, the ABSI scoring system is still a valuable tool to predict the deaths of burn patients.
Jafar Malmir; Ehsan Bolvardi; Monavar Afzal Aghaee
Abstract
The severe sepsis and septic shock are as common and lethal that emergency physicians routinely confront. Actually, more than two thirds of sepsis patients present initially to the ED. Only a few laboratory tests for markers of sepsis are currently available. The serum lactate level can help in determining ...
Read More
The severe sepsis and septic shock are as common and lethal that emergency physicians routinely confront. Actually, more than two thirds of sepsis patients present initially to the ED. Only a few laboratory tests for markers of sepsis are currently available. The serum lactate level can help in determining prognosis and to risk-stratify patients with severe sepsis. This independent review of the literature includes 83 studies published in all electronic-based database such as Elsevier, PubMed, and SID during the last 18 years (40–320 patients in each). Data gathered from English language articles and books published between 1995 and 2013. The serum lactate concentrations measured in almost all patients with severe sepsis raised at admission and were higher in patients who had the worst outcomes such as higher Apache-II and SOFA score. Serum lactate was associated with mortality independent of clinically apparent organ dysfunction and shock in patients with severe sepsis admitted to the emergency department and intensive care unit. This review focuses on the association between initial and serial serum lactate level and mortality in patients presenting to the emergency department with severe sepsis.