ABSTRACT
Introduction: Gattinoni et al. have recently introduced a new internal milieu parameter: the “alactic base excess” (ABE). This variable is obtained by applying the following equation: ABE mmol/L = standard base excess (SBE) mmol/L + lactate mmol/L, being standard base excess mmol/L = [bicarbonate mmol/L - 24.8 mmol/L] + 16.2 mmol/L x (pH - 7.4). In a clinical setting, a negative ABE value is directly related to fix acid retention, and is associated with higher mortality in septic patients. Hemoperfusion (HPF) is an extracorporeal technique which involves the passage of blood (or plasma) through an adsorption cartridge, where solutes are removed by direct binding to the sorbent material. Then, we decided to evaluate if HPF could modify negative ABE value in sepsis. Methods: Basal values of ABE, SBE and lactate (mean, SD) were obtained. The difference between these parameters values before and after 4 HPF (HA330) sessions (delta value) was evaluated. Student and Wilcoxon tests were applied for data analyses Results: From 32 patients (age: 57±13, male 69%) suffering from respiratory insufficiency secondary to COVID-19 (RIC) who were treated with HPF (HA330) in the critical care unit of Clinica de la Mujer, Bogotá (Colombia), 6 presented metabolic acidosis (pH:7.37±0.1, pCO2: 36±14 mmHg, bicarbonate:20.5±3 mmol/L) with negative ABE value (-2.7±1) composed by negative SBE (- 4.7±1) and high lactate serum value (2±0.7 mmol/L). Delta ABE, SBE and lactate were: 7.7 (p:0.005), 6.1 (p:0.003) and 1.6 (p:NS), respectively. Thus, negative ABE was significantly reversed by HPF, due to SBE positivization without significant change in lactate. Conclusions: Negative alactic parameter was significantly reversed by HPF in septic patients. No conflict of interest