Can venous base excess replace arterial base excess as a marker of early shock and a predictor of survival in trauma?

Singapore Medical Journal
Ramesh WijayaAndrew Siang Yih Wong

Abstract

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. 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. 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...Continue Reading

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Citations

Apr 12, 2018·The New England Journal of Medicine·Kenrick Berend
Dec 24, 2017·Scientific Reports·Simone PorcelliMichele Samaja
Apr 2, 2021·Emergency Medicine Journal : EMJ·Andrew R CogginsJeremy M Hsu

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