Occult Hypoperfusion — FRCA Final MCQ

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ModerateTrauma & Emergency AnaesthesiaOccult HypoperfusionFRCA Final

Trauma patient: lactate 6.2, base deficit -8, normal vital signs after initial resuscitation. What does this indicate?

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Correct answer: D — Compensated (occult) shock with ongoing tissue hypoperfusion

Elevated lactate + base deficit despite normal vitals = occult hypoperfusion (cryptic shock). Vitals normalise before tissue perfusion restored. Lactate >2 and BD >-6 are independent mortality predictors. Serial lactate clearance (>20%/2h) guides adequacy.

Reference: ATLS – 2018 – Endpoints of resuscitation