Of patients requiring ICU admission, 57% present with a metabolic acidosis and, in three-quarters of these, it is due to a raised lactate because of hypoperfusion. A raised lactate is associated with increased mortality. A base deficit of more than - 4 mmol litre-1 on admission to the ICU is associated with an in-hospital mortality of 57%, which rises to 70% if it is not corrected within 24 hours. The base deficit has been shown to correlate with intravascular fluid requirements in patients with trauma.
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