将血清乳酸作为败血症和创伤患者发病率和死亡率的预测指标进行评估

Vivek M. Kele, Lisha Suraj
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引用次数: 0

摘要

乳酸是细胞中葡萄糖无氧代谢生成三磷酸腺苷(ATP)时产生的,可作为先兆或全身灌注不足的指标。因此,本研究旨在评估连续测量血清乳酸水平在预测重症患者预后方面的价值。在获得机构伦理委员会的批准和亲属/患者的书面自愿知情同意后,共纳入了50例胸部或腹部外伤患者,以及根据快速器官功能衰竭顺序评估(qSOFA)评分患有脓毒症或患有系统性炎症反应综合征(SIRS)的患者。在 24 小时和 48 小时测量血清乳酸水平,并记录 nal 结果和出院时间。观察发现,血清乳酸水平在性别、是否存在多器官功能障碍综合征(MODS)和治疗类型方面相似。基线乳酸水平相似。死亡与 24 小时和 48 小时血清乳酸水平的显著上升有关,而血清乳酸水平的下降与提前出院(少于 7 天)有关。由此可以得出结论,血清乳酸水平的临床测量对于预测危重病人的预后具有重要价值,乳酸水平的升高预示着潜在的致命结局。
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EVALUATION OF SERUM LACTATE AS A PREDICTOR OF MORBIDITY AND MORTALITY IN SEPSIS AND TRAUMA PATIENTS
Lactate is produced in the cells in anaerobic metabolism of glucose for the generation of adenosine triphosphate (ATP) and may be an indicator of occult or global hypoperfusion. Thus, early serum lactate measurement may be a prognostic indicator of the outcome in critically ill patients. Therefore, the present study was conducted to assess the value of serial measurements of serum lactate levels in the predicting the outcome. After obtaining approval from the Institutional Ethics Committee and written voluntary informed consent from the relatives/patients, a total of 50 cases of trauma to chest or abdomen and patients with sepsis as per quick Sequential Organ Failure Assessment (qSOFA) score or having Systemic Inammatory Response Syndrome (SIRS) were included. Serum lactate levels were measured at 24 and 48 hours and the nal outcome and duration of discharge was noted. It was observed that serum lactate levels were similar in terms of gender, presence of multiple organ dysfunction syndrome (MODS) and type of treatment. Baseline lactate levels were similar. Death was associated with signicant increase in serum lactate levels at 24 and 48 hours while a decrease in levels were associated with early discharge (at less than 7 days). It can be effectively concluded that serial measurements of serum lactate levels are of prognostic value to predict the outcome in critically ill patient with increasing levels being a harbinger of potentially fatal outcomes.
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