Volume 19 Supplement 2
Prognostic evaluation from different types of acidosis in high-risk surgical patients
© Silva Junior et al. 2015
Published: 28 September 2015
Acidosis is a very frequent disorder in surgical patients. However, the nature of metabolic acidosis (hyperlactatemia, hyperchloremia, and others) seems to be indicative of worse clinical outcomes compared with pH value.
This study assessed the role of different types of acidosis in the outcome of high-risk surgeries.
Prospective, multicentric and observational study performed in three different tertiary hospitals. Patients who needed postoperative ICU admission were included in the study. Patients with low life expectancy (untreated cancer), hepatic failure, renal failure, and diabetes diagnosis were excluded. The patients were classified at ICU admission according to the presence and type of metabolic acidosis. The classification criteria were: base excess <-4 mmol/l; high albumin-corrected anion gap >12 mmol/l; and hyperlactatemia >2 mmol/l. Thus, acidosis was classified as hyperlactatemic, high or normal albumin-corrected anion gap (hyperchloremic).
Metabolic acidosis in surgical patients is a highly prevalent postoperative complication, mainly related to hyperchloremia. Depending on the type, patients who developed metabolic acidosis postoperatively exhibited the worst outcomes compared with patients without acidosis, and the specific acidosis diagnosis can help in management.
This article is published under license to BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.