Open Access, Peer-reviewed
pISSN 2288-6575
eISSN 2288-6796
    J Korean Surg Soc. 2011 Feb;80(2):84-89. Korean.
    Published online Feb 07, 2011.
    https://doi.org/10.4174/jkss.2011.80.2.84
    Copyright © 2011 The Korean Surgical Society
    Original Article

    Serum Lactate and Base Deficit: Early Predictors of Morbidity and Mortality in Burn Patients with Inhalation Injury

    Yong Suk Cho, M.D., Hyeong Tae Yang, M.D., Haejun Yim, M.D., Dohern Kim, M.D., Jun Hur, M.D.,1 Jong Hyun Kim, M.D. and Wook Chun, M.D.
      • Department of Burn Surgery, Burn Center, Hangang Sacred Heart Hospital, College of Medicine, Hallym University, Seoul, Korea.
      • 1Department of Pharmacology, Chung-Ang University College of Medicine, Seoul, Korea.
    • Corresponding author (Email: dohern@hallym.ac.kr )
    Received October 19, 2010; Accepted January 10, 2011.

    Abstract

    Purpose

    The aim of this study was to elucidate whether plasma lactate (PL) and base deficit (BD) are useful early parameters to predict the prognosis of burn patients with inhalation injury. In addition, one of the main objectives was to evaluate if PL and its change, BD and its change due to fluid resuscitation, adds additional information.

    Methods

    A retrospective review was performed on 151 patients admitted to our burn intensive care unit who were suspected to have inhalation burn injury, and then were confirmed by fibreoptic bronchoscopy between 1 Jan 2008 and 31 Dec 2008. All patients received proper fluid and electrolyte resuscitation, pain management, nutritional support, wound care and surgical debridement of dead tissue by burn surgeon.

    Results

    Initial PL, PL1 (24 hours later) and initial BD show statistical differences between survivors group and non-survivors group. A better chance of survival occurs when resuscitation results in normal PL values within 24 h. Moreover, an outcome predictor of shock and effective resuscitation could be defined by evaluating the changes of BD on Day 1. Normalization of the BD within 24 h is associated with a better chance of survival.

    Conclusion

    Measuring PL, BD and their changes may help to identify burn patients either for adequacy of treatment, or selection of other therapeutic options. Therefore titration of burn resuscitation to normalize PL and BD levels may be a reasonable method to improve burn mortality.

    Keywords
    Burn; Plasma lactate (PL); Base deficit (BD)

    Tables

    Table 1
    The demographics of patients

    Table 2
    Comparison of survivors and non-survivors

    Table 3
    Plasma lactate (PL) on Day (admission) and its changes on Day 1 and its related outcomes

    Table 4
    Base deficit (BD) on Day (admission) and its changes on Day 1 and its related outcomes

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    MeSH Terms
    Bronchoscopy
    Burns
    Burns, Inhalation
    Debridement
    Humans
    Inhalation
    Intensive Care Units
    Lactic Acid
    Nutritional Support
    Pain Management
    Plasma
    Prognosis
    Resuscitation
    Retrospective Studies
    Shock
    Survivors
    Metrics
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