Negative alactic base excess is reversed by hemoperfusion in septic patients

Autori

  • Carlos Guido Musso Facultad de Ciencias de la Salud, Universidad Simón Bolivar, Barranquilla - Colombia and Research Department, Hospital Italiano de Buenos Aires, Buenos Aires - Argentina
  • Juan P. Cordoba Clínica de la Costa, Barranquilla - Colombia
  • Gustavo Aroca-Marinez Facultad de Ciencias de la Salud, Universidad Simón Bolivar, Barranquilla; Clínica de la Costa, Barranquilla and Universidad del Norte, Barranquilla - Colombia
  • Sergio Terrasa Research Department, Hospital Italiano de Buenos Aires, Buenos Aires - Argentina
  • Adriana P. Barriga-Moreno Critical Care Division, Clínica de la Mujer, Bogotá - Colombia
  • Marcela Lozano-Sanchez Critical Care Division, Clínica de la Mujer, Bogotá - Colombia
  • Rafael A. Barón-Alvarez Critical Care Division, Clínica de la Mujer, Bogotá - Colombia
  • Henry Gonzalez-Torres Facultad de Ciencias de la Salud, Universidad Simón Bolivar, Barranquilla - Colombia
  • Joaquin Cantos Critical Care Division, Hospital Italiano de Buenos Aires, Buenos Aires - Argentina
  • Iván Huespe Critical Care Division, Hospital Italiano de Buenos Aires, Buenos Aires - Argentina

DOI:

https://doi.org/10.33393/gcnd.2022.2490

Parole chiave:

Alactic base excess, Hemoperfusion, Sepsis

Abstract

Introduction: Gattinoni et al. have recently introduced a new parameter: the “alactic base excess” (ABE). ABE is equivalent to the number of strong acids, other than lactate, which are present in the plasma in abnormal concentrations, negative ABE being associated with higher mortality in sepsis. Hemoperfusion (HPF) is an extracorporeal procedure that involves the passage of blood through an adsorption cartridge, where solutes are removed by direct binding to the sorbent material. Then, it was decided to explore the influence of HPF on negative ABE value in sepsis.

Materials and methods: Basal values of ABE, standard base excess (SBE), and lactate (mean, standard deviation [SD]) were obtained. The difference between these parameter values before and after four sessions of HPF (HA330) (delta value) was evaluated. Student’s t-test and Wilcoxon test were applied.

Results: From 32 patients (age: 57±13) suffering from respiratory insufficiency secondary to COVID-19 who were treated with HPF in the critical care unit of Clinica de la Mujer, Bogotá (Colombia), 6 patients presented with metabolic acidosis with negative ABE value (‒2.7±1) with negative SBE (‒4.7±1) and high lactate serum value (2±0.7 mmol/L). Delta ABE, SBE, and lactate were: 7.7 (p = 0.005), 6.1 (p = 0.003), and 1.6 (p = NS), respectively. Thus, negative ABE was significantly reversed by HPF, since SBE value turned positive without significant change in lactate.

Conclusion: Negative alactic parameter was significantly reversed by HPF in septic patients. It is necessary to carry out evaluations in larger groups to estimate their impact on clinical outcomes.

Riferimenti bibliografici

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Pubblicato

2022-12-19

Come citare

1.
Musso CG, Cordoba JP, Aroca-Marinez G, Terrasa S, Barriga-Moreno AP, Lozano-Sanchez M, Barón-Alvarez RA, Gonzalez-Torres H, Cantos J, Huespe I. Negative alactic base excess is reversed by hemoperfusion in septic patients. G Clin Nefrol Dial [Internet]. 19 dicembre 2022 [citato 4 febbraio 2023];34(1):122-4. Available at: https://journals.aboutscience.eu/index.php/gcnd/article/view/2490

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Articoli originali
Received 2022-09-09
Accepted 2022-11-24
Published 2022-12-19