Repositório Digital

A- A A+

Occult hypoperfusion is associated with increased mortality in hemodynamically stable, high-risk, surgical patients

.

Occult hypoperfusion is associated with increased mortality in hemodynamically stable, high-risk, surgical patients

Mostrar registro completo

Estatísticas

Título Occult hypoperfusion is associated with increased mortality in hemodynamically stable, high-risk, surgical patients
Autor Friedman, Gilberto
Meregalli, André Felipe
Oliveira, Roselaine Pinheiro de
Abstract Background Our aim was to examine whether serial blood lactate levels could be used as predictors of outcome. Methods We prospectively studied 44 high-risk, hemodynamically stable, surgical patients. Blood lactate values, mean arterial pressure, heart rate and urine output were obtained at patient admission to the study, at 12, 24 and 48 hours. Results The nonsurvivors (n=7) had similar blood lactate levels initially (3.1±2.3 mmol/l versus 2.2±1.0 mmol/l, P=not significant [NS]), but had higher levels after 12 hours (2.9±1.7 mmol/l versus 1.6±0.9 mmol/l, P=0.012), after 24 hours (2.1±0.6 mmol/l versus 1.5±0.7 mmol/l, P= NS) and after 48 hours (2.7±1.8 mmol/l versus 1.9±1.4 mmol/l, P=NS) as compared with the survivors (n=37). Arterial bicarbonate concentrations increased significantly in survivors and were higher than in nonsurvivors after 24 hours (22.9±5.2 mEq/l versus 16.7±3.9 mEq/l, P=0.01) and after 48 hours (23.1±4.1 mEq/l versus 17.6±7.1 mEq/l, P=NS). The PaO2/FiO2 ratio was higher in survivors initially (334± 121mmHg versus 241±133mmHg, P=0.03) and remained elevated for 48 hours. There were no significant differences in mean arterial pressure, heart rate, and arterial blood oxygenation at any time between survivors and nonsurvivors. The intensive care unit stay (40±42 hours versus 142±143 hours, P<0.001) and the hospital stay (12±11 days versus 24±17 days, P=0.022) were longer for nonsurvivors than for survivors. The Simplified Acute Physiology Score II score was higher for nonsurvivors than for survivors (34±9versus 25±14, P=NS). The urine output was slightly lower in the nonsurvivor group (P=NS). The areas under the receiving operating characteristic curves were larger for initial values of Simplified Acute Physiology Score II and blood lactate for predicting death. Conclusion Elevated blood lactate levels are associated with a higher mortality rate and postoperative complications in hemodynamically stable surgical patients.
Contido em Critical Care. London. Vol. 8, No. 2 (Apr. 2004), R60-65
Assunto Medicina
[en] High-risk surgical patients
[en] Hypoperfusion
[en] Lactate
[en] Metabolic acidosis
[en] Mortality
Origem Estrangeiro
Tipo Artigo de periódico
URI http://hdl.handle.net/10183/20074
Arquivos Descrição Formato
000505057.pdf (175.7Kb) Texto completo Adobe PDF Visualizar/abrir

Este item está licenciado na Creative Commons License

Este item aparece na(s) seguinte(s) coleção(ões)


Mostrar registro completo

Percorrer



  • O autor é titular dos direitos autorais dos documentos disponíveis neste repositório e é vedada, nos termos da lei, a comercialização de qualquer espécie sem sua autorização prévia.
    Projeto gráfico elaborado pelo Caixola - Clube de Criação Fabico/UFRGS Powered by DSpace software, Version 1.8.1.