Limits...
Utilization of base deficit and reliability of base deficit as a surrogate for serum lactate in the peri-operative setting.

Chawla LS, Nader A, Nelson T, Govindji T, Wilson R, Szlyk S, Nguyen A, Junker C, Seneff MG - BMC Anesthesiol (2010)

Bottom Line: Over 70% of respondents used BD as an endpoint of resuscitation.Base Deficit Study: 35 patients were enrolled resulting in 88 arterial blood gases with corresponding Lac.Lac can now be measured in the OR in real time.Therefore, if clinicians in the operative setting want to know the Lac, it should be measured directly.

View Article: PubMed Central - HTML - PubMed

Affiliation: Department of Critical Care Medicine and Anesthesiology George Washington University Medical Center, Washington D,C,, USA. lchawla@mfa.gwu.edu.

ABSTRACT

Background: Base deficit (BD) is commonly used in the operating room (OR) as an endpoint of resuscitation. BD is used as a surrogate marker for the accumulation of lactic acid(Lac). However, the BD can be affected by large amounts of saline.

Methods: We conducted a survey of anesthesiologists regarding the use of BD. We also studied the reliability of BD to determine the presence of hyperlactatemia (HL). Patients undergoing general anesthesia were eligible for enrollment if they were receiving an arterial line as part of their routine care. If an arterial blood gas was drawn by the operative team as part of the routine care, the remainder of the unused blood was also used to measure Lac.

Survey: 73 staff anesthesiologists were surveyed. Over 70% of respondents used BD as an endpoint of resuscitation.Base Deficit Study: 35 patients were enrolled resulting in 88 arterial blood gases with corresponding Lac. Mean age was 61.4 ± 14.3 years, 43% were male. Mean pH was 7.39 ± 0.05, the mean bicarbonate was 23.0 ± 2.3 meq/L, the mean BD 1.34 ± 2.3, and the mean Lac was 1.58 ± 0.71 mmol/L. Mean ASA risk score was 3.16 ± 0.71. ROC area under the curve for base deficit to detect HL was 0.58.

Conclusion: BD can often mislead the clinician as to the actual Lac. Lac can now be measured in the OR in real time. Therefore, if clinicians in the operative setting want to know the Lac, it should be measured directly.

No MeSH data available.


Survey.
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Figure 1: Survey.

Mentions: We conducted a survey (Figure 1) of anesthesiology attendings and residents at 3 academic medical centers (Washington Hospital Center Hospital, Washington DC, George Washington University Medical Center, Washington DC, and University of North Carolina, Chapel Hill, NC). The survey was approved by the George Washington University Medical Center Institutional Review Board and granted a waiver of HIPAA (Health Insurance Portability and Accountability Act) and informed consent. No personal identifiable material was collected.


Utilization of base deficit and reliability of base deficit as a surrogate for serum lactate in the peri-operative setting.

Chawla LS, Nader A, Nelson T, Govindji T, Wilson R, Szlyk S, Nguyen A, Junker C, Seneff MG - BMC Anesthesiol (2010)

Survey.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC2944305&req=5

Figure 1: Survey.
Mentions: We conducted a survey (Figure 1) of anesthesiology attendings and residents at 3 academic medical centers (Washington Hospital Center Hospital, Washington DC, George Washington University Medical Center, Washington DC, and University of North Carolina, Chapel Hill, NC). The survey was approved by the George Washington University Medical Center Institutional Review Board and granted a waiver of HIPAA (Health Insurance Portability and Accountability Act) and informed consent. No personal identifiable material was collected.

Bottom Line: Over 70% of respondents used BD as an endpoint of resuscitation.Base Deficit Study: 35 patients were enrolled resulting in 88 arterial blood gases with corresponding Lac.Lac can now be measured in the OR in real time.Therefore, if clinicians in the operative setting want to know the Lac, it should be measured directly.

View Article: PubMed Central - HTML - PubMed

Affiliation: Department of Critical Care Medicine and Anesthesiology George Washington University Medical Center, Washington D,C,, USA. lchawla@mfa.gwu.edu.

ABSTRACT

Background: Base deficit (BD) is commonly used in the operating room (OR) as an endpoint of resuscitation. BD is used as a surrogate marker for the accumulation of lactic acid(Lac). However, the BD can be affected by large amounts of saline.

Methods: We conducted a survey of anesthesiologists regarding the use of BD. We also studied the reliability of BD to determine the presence of hyperlactatemia (HL). Patients undergoing general anesthesia were eligible for enrollment if they were receiving an arterial line as part of their routine care. If an arterial blood gas was drawn by the operative team as part of the routine care, the remainder of the unused blood was also used to measure Lac.

Survey: 73 staff anesthesiologists were surveyed. Over 70% of respondents used BD as an endpoint of resuscitation.Base Deficit Study: 35 patients were enrolled resulting in 88 arterial blood gases with corresponding Lac. Mean age was 61.4 ± 14.3 years, 43% were male. Mean pH was 7.39 ± 0.05, the mean bicarbonate was 23.0 ± 2.3 meq/L, the mean BD 1.34 ± 2.3, and the mean Lac was 1.58 ± 0.71 mmol/L. Mean ASA risk score was 3.16 ± 0.71. ROC area under the curve for base deficit to detect HL was 0.58.

Conclusion: BD can often mislead the clinician as to the actual Lac. Lac can now be measured in the OR in real time. Therefore, if clinicians in the operative setting want to know the Lac, it should be measured directly.

No MeSH data available.