Ramesh Wijaya1, Jia Hui Ng2, Lester Ong3, Andrew Siang Yih Wong1. 1. Department of General Surgery, Changi General Hospital, Singapore. 2. Department of Otolaryngology, SingHealth, Singapore. 3. Department of General Surgery, SingHealth, Singapore.
Abstract
INTRODUCTION: Arterial base excess is an established marker of shock and predictor of survival in trauma patients. However, venous blood is more quickly and easily obtained. This study aimed to determine if venous base excess could replace arterial base excess as a marker in trauma patients at presentation and if venous base excess is predictive of survival at 24 hours and one week. METHODS: This was a prospective study of 394 trauma patients presenting to the emergency department of a tertiary hospital over a 17-month period. Data on base excess at presentation, vital signs, shock index (SI), injury severity score (ISS), and mortality at 24 hours and one week was collected and analysed. RESULTS: Arterial and venous blood gas tests were performed on 260 and 134 patients, respectively. Patients were stratified into groups based on their SI and ISS for analysis. There was no statistical difference between mean venous blood gas and arterial blood gas levels at presentation when SI > 0.7, regardless of ISS (p > 0.05). The mortality rate was 4.57%. Both venous and arterial base excess was lower in nonsurvivors compared to survivors (p < 0.05). However, at 24 hours and one week, the difference in base excess values at presentation between survivors and nonsurvivors was greater when using venous base excess compared to arterial base excess (11.53 vs. 4.28 and 11.41 vs. 2.66, respectively). CONCLUSION: In conclusion, venous base excess can replace arterial base excess in trauma patients as a means of identifying and prognosticating early shock.
INTRODUCTION: Arterial base excess is an established marker of shock and predictor of survival in traumapatients. However, venous blood is more quickly and easily obtained. This study aimed to determine if venous base excess could replace arterial base excess as a marker in traumapatients at presentation and if venous base excess is predictive of survival at 24 hours and one week. METHODS: This was a prospective study of 394 traumapatients presenting to the emergency department of a tertiary hospital over a 17-month period. Data on base excess at presentation, vital signs, shock index (SI), injury severity score (ISS), and mortality at 24 hours and one week was collected and analysed. RESULTS: Arterial and venous blood gas tests were performed on 260 and 134 patients, respectively. Patients were stratified into groups based on their SI and ISS for analysis. There was no statistical difference between mean venous blood gas and arterial blood gas levels at presentation when SI > 0.7, regardless of ISS (p > 0.05). The mortality rate was 4.57%. Both venous and arterial base excess was lower in nonsurvivors compared to survivors (p < 0.05). However, at 24 hours and one week, the difference in base excess values at presentation between survivors and nonsurvivors was greater when using venous base excess compared to arterial base excess (11.53 vs. 4.28 and 11.41 vs. 2.66, respectively). CONCLUSION: In conclusion, venous base excess can replace arterial base excess in traumapatients as a means of identifying and prognosticating early shock.
Authors: Manuel Mutschler; Ulrike Nienaber; Matthias Münzberg; Christoph Wölfl; Herbert Schoechl; Thomas Paffrath; Bertil Bouillon; Marc Maegele Journal: Crit Care Date: 2013-08-12 Impact factor: 9.097
Authors: Ali Taherinia; Ghazal Saba; Mohsen Ebrahimi; Koorosh Ahmadi; Zabihollah Taleshi; Peyman Khademhosseini; Ali Soltanian; Atie Safaee; Mehran Bahramian; Shahin Gharakhani; Mohammad Ali Jafari Nodoshan Journal: J Family Med Prim Care Date: 2021-07-30