Lactate, Unmeasured Anions and Chloride as Predictors to the Outcome of Critically Ill Patients with Liver Cirrhosis

Abstract Background Liver Cirrhosis is widely prevalent worldwide and can be a consequence of different causes, such as obesity, non-alcoholic fatty liver disease, high alcohol consumption, hepatitis B or C infection, autoimmune diseases, cholestatic diseases, and iron or copper overload. Cirrhosis develops after a long period of inflammation that results in replacement of the healthy liver parenchyma with fibrotic tissue and regenerative nodules, leading to portal hypertension. Aim of the Work The aim of the present study is to asses effect of serum lactate, Unmeasured anions and Chloride as predictors to the outcome of critically ill patients with liver cirrhosis. Patients and Methods This study was conducted on 95 patients divided to 4 groups according type of metabolic acidosis (lactic acidosis group, unmeasured anions acidosis group, hyperchloremic acidosis group, indeterminate acidosis group). Results This present study showed strong significance between (lactic acidosis), (unmeasured anion acidosis) and mortality incidence when compared with APACHE II score on day 0 (admission day). Where as hyperchloremia (hyperchloremic acidosis) was independently related to outcome. Conclusion The main finding in this study was that lactic acidosis constitutes the most common type of metabolic acidosis at the admission of critically ill patients. lactate, unmeasured anions were independent predictors of outcome. Any elevation in the concentration of these anions was associated with increasing Mortality. While, hyperchloremia was negatively related to mortality.