Introduction:

Trauma is one of the main causes of death worldwide. The metabolic response culminates with inadequate oxygen delivery and anaerobic metabolism, the final product being lactate. High lactate levels at admission and slow or incomplete return to normal values are associated with higher mortality.

Materials and methods:

Prospective cohort study in patients older than 18 years with severe penetrating trauma taken to emergent surgery and post-surgery in intensive or especial care unit in the period June 2016 to November 2017. Some severity scores and lactate values were determined at admission, and at 6, 12, 18 and 24 hours. The outcome variables were mortality, length of hospital stay and surgical site infection. To estimate the associations we used a bivariate analysis and a multiple linear regression model.

Results:

130 patients were included, registering 8 deaths (6.2%). There was no association between lactate clearance and incidence of surgical site infection. Absolute lactate values at admission were significantly higher in the deceased; a tendency to a lower percentage of clearance was recorded in the deceased at 24 hours; at 12 hours after admission, the survivors had a clearance of more than 50% of the lactate and the deceased 25.7%. More than half of the patients did not clear 50% of the initial value of lactate at 6, 12 and 24 hours.

Conclusion:

The usefulness of lactate monitoring during the first 24 hours as a prognostic factor in patients with severe penetrating trauma is demonstrated.

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