Korisnost baznog deficita u proceni vrednosti serumskih laktata kod kritično obolelih pacijenata na mehaničkoj ventilaciji
Sažetak
Uvod/Cilj: Acido-bazni poremećaji su uobičajeni kod kritično obolelih pacijenata. Jedni od najčešće korišćenih markera metaboličke acidoze su bazni deficit i serumski laktati. Cilj ove studije je bio da se ispita povezanost između baznog deficita i serumskih laktata, kao i korisnost baznog deficita u procenjivanju vrednosti serumskih laktata kod kritično obolelih pacijenata na mehaničkoj ventilaciji.
Metode: Studija je dizajnirana kao retrospektivna, analitička studija. Pregledali smo sve arterijske gasne analize pacijenata na mehaničkoj ventilaciji, kojima su određivani bazni deficit i laktati. Korelacija između baznog deficita i laktata procenjivana je pomoću Pearsonovog koeficijenta korelacije (r) i koeficijenta determinacije (R2). ROC krive su konstruisane za bazni deficit radi procene prisustva hiperlaktatemije. Za statističku obradu podataka korišćen je SPSS 12.0 (Čikago, Ilinois) softverski paket.
Rezultati: 142 pacijenta, preživeli (n=68) i umrli (n=74). Srednja vrednost baznog deficita bila je 0.512 ± 6.10 mmol/L; srednja vrednost serumskih laktata bila je 2.04 ± 2.07 mmol/L. Nije bilo statistički značajne razlike između grupa za laktate i bazni deficit (p=0.101, p=0.106 redom). Hiperlaktatemija je primećena kod 44 pacijenta (30,98%). ROC površina ispod krive za bazni deficit da otkrije hiperlaktatemiju bila je 0.527.
Zaključak: Ova studija ukazuje da bazni deficit nije adekvatan marker u evaluaciji stvarnih vrednosti serumskih laktataReference
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