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Crit Care. 2010; 14(Suppl 1): P161.
Published online 2010 March 1. doi:  10.1186/cc8393
PMCID: PMC2934253

Examination of the utility of serum lactate and base deficit in hemorrhagic shock

Introduction

Serum lactate and base deficit are markers of tissue ischemia and are used to assess the adequacy of resuscitation. Recent reports have shown that they are also useful markers associated with the severity and prognosis of sepsis and trauma; however, there are few reports regarding their use in hemorrhagic shock. We examined the utility of serum lactate and base deficit about the patients with upper gastrointestinal hemorrhagic shock. We thought that upper gastrointestinal hemorrhage cases reflected hemorrhagic clinical conditions of hemorrhagic shock rather than trauma.

Methods

We retrospectively reviewed the cases of 152 consecutive patients with upper gastrointestinal hemorrhage and analyzed the relationships between levels of serum lactate, base deficit and hemorrhagic shock on admission. We divided the patients into two groups according to whether their shock index (systolic blood pressure/pulse) was less than 1 (shock group, n = 57; 37.5%) or greater than 1 (nonshock group, n = 95; 62.5%).

Results

Among the 152 patients included in the analysis, 97 had gastric ulcers, 18 had esophageal varices, 17 had duodenal ulcers, seven had acute gastric mucosal lesions, six had gastric carcinoma, five had Mallory-Weiss syndrome, and two had gastric varices. The study cohort comprised 27% women (n = 41) and 73% men (n = 111). The median age was 62.2 ± 15.1 years. On admission, the average serum lactate level was 3.4 ± 4.2 mmol/l, and the base deficit was -2.4 ± 5.1 mmol/l. The serum lactate level and base deficit were significantly higher in the shock group than in the nonshock group (5.8 ± 5.5 vs 2.0 ± 2.4 mmol/l, P < 0.001, and -4.4 ± 5.8 vs -1.0 ± 4.1 mmol/l, P = 0.002, respectively).

Conclusions

We observed a relationship between serum lactate level, base deficit value and hemorrhagic shock in patients with upper gastrointestinal hemorrhage.

References


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