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Indian Journal of Emergency Medicine

Volume  3, Issue 2, Jul-Dec 2017, Pages 203-210
 

Original Article

Prognosis of Haemodynamically Unstable Patients Secondary to Trauma Based on Lactate Clearance

Khan Khader Ali1, Begum Naheeda Shaik1, Shabbir Mohammed2, Samir Mohammed3

1Consultant, Dept of Emergency Medicine, P.E.S. Institute of Medical Sciences and Research, Kuppam, Andhra Pradesh 517425, India. 2Consultant & Head, Department of Emergency Medicine & Critical Care, Sparsh Hospital, Bommasandra, Bengaluru, Karnataka 560099, India. 3Senior Consultant, Dept of Emergency Medicine, BGS Global Hospital, Bengaluru, Karnataka 560060, India.

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DOI: http://dx.doi.org/10.21088/ijem.2395.311X.3217.5

Abstract

TRAUMA is the third overall cause of death and the first cause of death before 40 yr of age [1]. Early recognition of haemorrhage and shock in traumatic patients can prevent death, most deaths (80%) occurring within 48 hrs, haemorrhage being the leading cause of death [1]. Estimation of lactate clearance can be used as a diagnostic and prognostic biomarker in case of trauma patients [1]. Aims: To establish the prognostic significance of the lactate clearance in unstable trauma patients. Settings and Design: This is a “prospective observational study“among the patients who presented to the Emergency Department of BGS Global Hospital. Methods and Material: The patients will undergo ABG or VBG, as feasible along with blood lactate estimation which shall be repeated after 4 hours and the lactate clearance is calculated for 4 hrs. Statistical Analysis Used: All quantitative data are analysed using mean, median and standard deviation. All qualitative data are analysed using the chisquare test. Results: According to the lactate clearance values, the death rate was high at higher lactate clearance values and the discharge rate was high with lower lactate clearance values. According to the initial lactate values, the discharge rates are high with low initial lactate levels than at higher initial lactate levels. Conclusion: This study concludes that all the trauma patients with lower Lactate clearance and lower initial lactate levels had better outcome when compared with those who had high lactate clearance and high initial lactate levels at the time of admission.

Keywords: Lactate Clearance; Trauma; Heamorrhage; Shock; Initial Lactate Values. 


Corresponding Author : Begum Naheeda Shaik, Consultant, Dept. of Emergency Medicine P.E.S. Institute of Medical Sciences and Research, Kuppam, Andhra Pradesh 517425, India.