• Marcelo Park, Luciano Cesar Pontes Azevedo, Alexandre Toledo Maciel, Vladimir Ribeiro Pizzo, Danilo Teixeira Noritomi, and Luiz Monteiro da Cruz Neto.
• Intensive Care Unit, Emergency Department, São Paulo University Medical School--São Paulo/SP, Brazil. mpark@uol.com.br
• Clinics (Sao Paulo). 2006 Feb 1;61(1):47-52.

PurposeTo compare the evolution of standard base excess and serum lactate level between surviving and non surviving patients with severe sepsis and septic shock resuscitated with early goal-directed therapy.MethodsThis is a retrospective study in an intensive care unit of a university tertiary hospital where 65 consecutive severe sepsis and septic shock patients were observed without any intervention in the treatment by the authors of this report.ResultsIn our study, the mortality of severe sepsis and septic shock patients was 38%. The central venous oxygen saturation of both groups was above 70% after the resuscitative period, excluding the second day of the non survivors group (69.8%). After the second day, the central venous oxygen saturation was significantly higher in the survivors group (P < .001). Standard base excess was initially low in both groups, but from the second day on, the correction of standard base excess was significantly more successful and linear in the survivor group (P < .001). Lactate levels were similar during the evolution of both groups.ConclusionsAlthough evolutive standard base excess and serum lactate level are still outcome markers in severe sepsis and septic shock patients resuscitated with early goal-directed therapy, other studies must be performed to clarify if hemodynamic interventions based on standard base excess and serum lactate level could be reliable to improve clinical outcomes in severe sepsis and septic shock patients.

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