Mutschler et al used base deficit as the criteria for classifying a trauma patient with hypovolemia. This correlates with blood product requirements and outcome. The authors are the German Society for Trauma Surgery (DGU).
Base deficit is a negative base excess. A rising base deficit is associated with a rising blood lactate concentration. The risk associated with the base deficit has been previously reported by Davis et al (1996) and Lavery et al (2000).
Parameter: base deficit on admission
Base Deficit
Hypovolemic Shock
Class
Need for Blood Product Transfusion
<= 2 mmol/L
none
I
low (watch)
2.01 to 6.0
mild
II
low to moderate (consider, need for massive transfusion 16%))
6.01 to 10
moderate
III
moderate to high (need for massive transfusion in 33%)
> 10 mmol/L
severe
IV
high (need for massive transfusion in 50%)
A patient with a high base deficit is more likely:
(1) to need for vasopressors
(2) to have an elevated blood lactate concentration
(3) to receive a volume of intravenous fluid resuscitation
(4) to die, with an overall mortality 50% in Class IV
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