• Ludhmila Abrahão Hajjar, Rosana Ely Nakamura, Juliano Pinheiro de Almeida, Julia T Fukushima, Paulo Marcelo Gehm Hoff, Jean-Louis Vincent, José Otávio Costa Auler, and Filomena Regina Barbosa Gomes Galas.
• Universidade de São Paulo, Cancer Institute, Department of Anesthesiology and Critical Care, Intensive Care Unit, São Paulo/SP, Brazil. ludhmila@terra.com.br
• Clinics (Sao Paulo). 2011 Jan 1; 66 (12): 2037-42.

ObjectiveCancer 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.MethodsWe 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.ResultsThere 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.ConclusionOur 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.

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