title: Effects of methamphetamine on trauma patients: a cause of severe metabolic acidosis?
abstract: OBJECTIVE
  Presentation of a trauma patient with severe unexplained metabolic acidosis, possibly attributable to the vasoconstrictive properties of smokable "crystal" methamphetamine. In addition, a review of trauma registry data was undertaken to determine the effects of methamphetamine on trauma patients.
  
  
  METHODS
  Case report and retrospective case-control study.
  
  
  METHODS
  Urban tertiary teaching hospital.
  
  
  METHODS
  Two controls were obtained for each case controlling for age, Injury Severity Score, and mechanism of injury. Patients > or =16 yrs of age with a urine toxicology screen positive for methamphetamine were included.
  
  
  RESULTS
  Data were obtained from the trauma registry for the period of January 1994 to June 1995. Trauma patients using methamphetamine had a significantly lower blood alcohol level compared with the control group. Otherwise, there were no significant differences detected in vital signs, laboratory values, procedures, treatment, or outcome between the two groups. Details regarding one patient who presented with severe life-threatening acidosis are presented.
  
  
  CONCLUSIONS
  Trauma patients with recent use of smokable methamphetamine may present with severe acidosis requiring urgent attention and treatment. This acidosis may exaggerate the severity of the actual injury. However, urine testing for methamphetamine does not identify patients who may harbor this acidosis.
authors.affiliation: School of Medicine, University of Hawaii and the Queen's Medical Center, Honolulu, USA.
authors.forename: S A
authors.initials: SA
authors.lastname: Burchell
authors.forename: H C
authors.initials: HC
authors.lastname: Ho
authors.forename: M
authors.initials: M
authors.lastname: Yu
authors.forename: D R
authors.initials: DR
authors.lastname: Margulies
mesh_terms: D000138:Acidosis / Q000139:chemically induced*; D000328:Adult; D000697:Central Nervous System Stimulants / Q000009:adverse effects*; D006801:Humans; D008297:Male; D008694:Methamphetamine / Q000009:adverse effects*; D012189:Retrospective Studies; D012720:Severity of Illness Index; D019966:Substance-Related Disorders
chemical_list: D000697:Central Nervous System Stimulants; D008694:Methamphetamine