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
Specialty: Surgery, orthopedic, Emergency Medicine, Critical Care, Surgery, general
ICD-10: ,