Episode 18 – Fluid Resuscitation: What to Base It On

 

Base deficit and excess are reliable biomarkers in determining the severity of our patients’ conditions. But is a deficit an automatic indicator for fluid resuscitation, as some may believe? Tune in as we discuss acid/base balance and what you should and should not base fluid resuscitation on. We also include an updated mnemonic that will help you remember the causes of metabolic acidosis:

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Abdul-Malak, O., Vodovotz, Y., Zaaqoq, A., Guardado, J., Almahmoud, K., Yin, J., . . . Namas, R. (2016). Mediators of Inflammation. Elevated Admission Base Deficit Is Associated with a Complex Dynamic Network of Systemic Inflammation Which Drives Clinical Trajectories in Blunt Trauma Patients, 2016. Retrieved from https://www.hindawi.com/journals/mi/2016/7950374/.

Bordes, B., Walia, H., & Sebastian, R. (2016). Correlation of Lactic Acid and Base Deficit Values Obtained From Arterial and Peripheral Venous Samples in a Pediatric Population During Intraoperative Care. Journal of Intensive Care Medicine, 32(10), 585-587. Retrieved from http://journals.sagepub.com/doi/abs/10.1177/0885066616684122

Chawla, L. S., Nadir, A., Nelson, T., Govindji, T., Wilson, R., Szlyk, S., . . . Seneff, M. G. (2010). Utilization of base deficit and reliability of base deficit as a surrogate for serum lactate in the peri-operative setting. BMC Anesthesiol, 10(16). Retrieved May 2, 2018, from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2944305/#__ffn_sectitle

Davis, J. W., Dirks, R. C., Kaups, K. L., & Tran, P. (2018). Base deficit is superior to lactate in trauma. The American Journal of Surgery, 215(4), 682-685. Retrieved May 2, 2018, from https://www.sciencedirect.com/science/article/pii/S0002961017305457

Gustafson, M., Hollosi, S., Chumbe, J., Samanta, D., Modak, A., & Bethea, A. (2015). The effect of ethanol on lactate and base deficit as predictors of morbidity and mortality in trauma. American Journal of Emergency Medicine, 33(5), 607-613. Retrieved from http://europepmc.org/articles/PMC4453763;jsessionid=B040B723034DFE184CA41F30965A26AF

Knowmedge . (2018). Retrieved May 2, 2018, from http://knowmedge.com/blog/medical-mnemonics-anion-gap-acidosis-goldmark/

Sabogal, C., Rivera, A., & Higuera, A. (2014). Lactate and base deficit in trauma: Prognostic value. Colombian Journal of Anesthesiology, 42(1), 60-64. Retrieved from https://www.sciencedirect.com/science/article/pii/S2256208713000606.

Raux, M., Le Manach, Y., Gauss, T., Baumgarten, R., & Hamada, S. (2017). Comparison of the Prognostic Significance of Initial Blood Lactate and Base Deficit in Trauma Patients. The Journal of the American Society of Anesthesiologists, 126(3), 522-533. Retrieved from http://anesthesiology.pubs.asahq.org/article.aspx?articleid=2598359

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