SEVERE ACIDOSIS ALONE DOES NOT PREDICT MORTALITY IN THE TRAUMA PATIENT

BACKGROUND: Because severe acidosis is an indicator of poor prognosis in trauma patients, medical records of these patients were analyzed to determine whether aggressive resuscitation was appropriate. PATIENTS AND METHODS: Data from a level 1 trauma center registry were reviewed retrospectively to identify patients with a pH less than or equal to 7 .0. Thirty-seven patients were identified, Severely acidotic patients were compared to average trauma patients in terms of demographics, res uscitation, injury, and outcome, Surviving acidotic patients were also compared to nonsurviving acidotic patients. RESULTS: Half of the seve rely acidotic group survived initial resuscitation with approximately one third surviving to leave the hospital, There were no chronically d isabled survivors. Nonsurviving acidotic patients were more unstable, more neurologically depressed, and more severely injured, Resuscitatio n efforts did not consume excessive hospital resources. CONCLUSION: Se vere acidosis alone is not a sufficiently powerful predictor of outcom e to justify withholding resuscitation; however, when combined with co ma and shock, this condition had no survivors in this small series.