Anion gap, anion gap corrected for albumin, and base deficit fail to accurately diagnose clinically significant hyperlactatemia in critically ill patients

Journal of Intensive Care Medicine

Volumn 23, Issue 2, 2008, Pages 122-127

  Chawla, Lakhmir S ^a   Jagasia, Dhiraj ^a   Abell, Lynn M ^a   Seneff, Michael G ^a   Egan, Melinda ^a   Danino, Natale ^a   Nguyen, Aline ^a   Ally, Mazer ^a   Kimmel, Paul L ^a   Junker, Christopher ^a  

^a GEORGE WASHINGTON UNIVERSITY MEDICAL CENTER   (United States)

Author keywords

Albumin corrected anion gap; Anion gap; Base deficit; Lactate; Shock

Indexed keywords

CREATININE; LACTIC ACID; SERUM ALBUMIN;

ADULT; AGED; ANION GAP; ARTICLE; CREATININE BLOOD LEVEL; CRITICALLY ILL PATIENT; DEMOGRAPHY; DIAGNOSTIC ACCURACY; FEMALE; HUMAN; HYPERLACTATEMIA; LACTATE BLOOD LEVEL; MAJOR CLINICAL STUDY; MALE; PRIORITY JOURNAL; PROSPECTIVE STUDY; SENSITIVITY AND SPECIFICITY; STATISTICAL ANALYSIS; UREA NITROGEN BLOOD LEVEL;

ACID-BASE EQUILIBRIUM; ACIDOSIS, LACTIC; BLOOD CHEMICAL ANALYSIS; FEMALE; HUMANS; HYPOALBUMINEMIA; MALE; MIDDLE AGED; RETROSPECTIVE STUDIES; ROC CURVE; SENSITIVITY AND SPECIFICITY; SHOCK;

EID: 41149145255     PISSN: 08850666     EISSN: 15251489     Source Type: Journal    
DOI: 10.1177/0885066607312985     Document Type: Article

References (18)

1. Husain FA, Martin MJ, Mullenix PS, Steele SR, Elliott DC Serum lactate and base deficit as predictors of mortality and morbidity. Am.J.Surg. 185: 485-491 ; 2003.
2. Nguyen HB, Rivers EP, Knoblich BP, et al. Early lactate clearance is associated with improved outcome in severe sepsis and septic shock. Crit Care Med. 32: 1637-1642 ; 2004.
3. Chiolero RL, Revelly JP, Leverve X., et al. Effects of cardiogenic shock on lactate and glucose metabolism after heart surgery. Crit Care Med. 28: 3784-3791 ; 2000.
4. Gutierrez G., Wulf ME Lactic acidosis in sepsis: another commentary. Crit Care Med. 33: 2420-2422 ; 2005.
5. Shoemaker WC, Appel PL, Kram HB Role of oxygen debt in the development of organ failure sepsis, and death in high-risk surgical patients. Chest. 102: 208-215 ; 1992.
6. Martin M., Murray J., Berne T., Demetriades D., Belzberg H. Diagnosis of acid-base derangements and mortality prediction in the trauma intensive care unit: the physiochemical approach. J.Trauma. 58: 238-243 ; 2005.
7. Rivers E., Nguyen B., Havstad S., et al. Early goal-directed therapy in the treatment of severe sepsis and septic shock. N Engl.J Med. 345: 1368-1377 ; 2001.
8. Shoemaker WC, Thangathurai D., Wo CC, et al. Intraoperative evaluation of tissue perfusion in high-risk patients by invasive and noninvasive hemodynamic monitoring. Crit Care Med. 27: 2147-2152 ; 1999.
9. Levraut J., Bounatirou T., Ichai C., et al. Reliability of anion gap as an indicator of blood lactate in critically ill patients. Intensive Care Med. 23: 417-422 ; 1997.
10. Iberti TJ, Leibowitz AB, Papadakos PJ, Fischer EP Low sensitivity of the anion gap as a screen to detect hyperlactatemia in critically ill patients. Crit Care Med. 18: 275-277 ; 1990.
11. Jeng JC, Jablonski K., Bridgeman A., Jordan MH Serum lactate, not base deficit, rapidly predicts survival after major burns. Burns. 28: 161-166 ; 2002.
12. Mikulaschek A., Henry SM, Donovan R., Scalea TM Serum lactate is not predicted by anion gap or base excess after trauma resuscitation. J Trauma. 40: 218-222 ; 1996.
13. Singh RN, Singh NC, Hutchison J., Moses GC Lower anion gap increases sensitivity in predicting elevated lactate. Clin Intensive Care. 5: 221-224 ; 1994.
14. Hatherill M., Waggie Z., Purves L., Reynolds L., Argent A. Correction of the anion gap for albumin in order to detect occult tissue anions in shock. Arch Dis Child. 87: 526-529 ; 2002.
15. Siggaard-Andersen O. The van Slyke equation. Scand J Clin Lab Invest Suppl. 37: 15-20 ; 1977.
16. Figge J., Jabor A., Kazda A., Fencl V. Anion gap and hypoalbuminemia. Crit Care Med. 26: 1807-1810 ; 1998.
17. Rocktaeschel J., Morimatsu H., Uchino S., Bellomo R. Unmeasured anions in critically ill patients: can they predict mortality? Crit Care Med. 31: 2131-2136 ; 2003.
18. Waters JH, Miller LR, Clack S., Kim JV Cause of metabolic acidosis in prolonged surgery. Crit Care Med. 27: 2142-2146 ; 1999.