title: Lactate and base deficit are predictors of mortality in critically ill patients with cancer.
abstract: OBJECTIVE
  Cancer patients frequently require admission to intensive care unit. However, there are a few data regarding predictive factors for mortality in this group of patients. The aim of this study was to evaluate whether arterial lactate or standard base deficit on admission and after 24 hours can predict mortality for patients with cancer.
  
  
  METHODS
  We evaluated 1,129 patients with severe sepsis, septic shock, or postoperative after high-risk surgery. Lactate and standard base deficit collected at admission and after 24 hours were compared between survivors and non-survivors. We evaluated whether these perfusion markers are independent predictors of mortality.
  
  
  RESULTS
  There were 854 hospital survivors (76.5%). 24 h lactate > 1.9 mmol/L and standard base deficit < -2.3 were independent predictors of intensive care unit mortality. 24 h lactate >1.9 mmol/L and 24 h standard base deficit < -2.3 mmol/Lwere independent predictors of hospital death.
  
  
  CONCLUSIONS
  Our findings suggest that lactate and standard base deficit measurement should be included in the routine assessment of patients with cancer admitted to the intensive care unit with sepsis, septic shock or after high-risk surgery. These markers may be useful in the adequate allocation of resources in this population.
authors.affiliation: Universidade de São Paulo, Cancer Institute, Department of Anesthesiology and Critical Care, Intensive Care Unit, São Paulo/SP, Brazil. ludhmila@terra.com.br
authors.forename: Ludhmila Abrahão
authors.initials: LA
authors.lastname: Hajjar
authors.forename: Rosana Ely
authors.initials: RE
authors.lastname: Nakamura
authors.forename: Juliano Pinheiro
authors.initials: JP
authors.lastname: de Almeida
authors.forename: Julia T
authors.initials: JT
authors.lastname: Fukushima
authors.forename: Paulo Marcelo Gehm
authors.initials: PM
authors.lastname: Hoff
authors.forename: Jean-Louis
authors.initials: JL
authors.lastname: Vincent
authors.forename: José Otávio Costa
authors.initials: JO
authors.lastname: Auler
authors.forename: Filomena Regina Barbosa Gomes
authors.initials: FR
authors.lastname: Galas
mesh_terms: D000137:Acid-Base Imbalance / Q000097:blood / Q000401:mortality*; D016638:Critical Illness / Q000401:mortality; D005260:Female; D017052:Hospital Mortality; D006801:Humans; D019344:Lactic Acid / Q000097:blood*; D008297:Male; D008875:Middle Aged; D009369:Neoplasms / Q000097:blood* / Q000401:mortality*; D011237:Predictive Value of Tests; D016019:Survival Analysis
chemical_list: D019344:Lactic Acid