Outcome prediction at ED disposition has not been fully studied, however, some clinical variables are associated with poor outcome: severity of shock, temporal duration, underlying cause, preexisting vital organ dysfunction, and reversibility. Direct noninvasive measurement of V o2 has been shown to be predictive of outcome in patients who developed cardiogenic shock secondary to myocardial infarction and after cardiac arrest. 423 Serial elevated lactic acid levels have been shown to be predictive in trauma, septic shock, and after cardiac arrest.424 Base-deficit correction has also been correlated with the development of multisystem organ failure in trauma.25 Outcome predictions using physiologic scoring systems in the ED are currently being studied. 3

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