用皮下微透析监测休克患者的乳酸:一项初步研究。

Circulatory shock Pub Date : 1994-06-01
J de Boer, H Potthoff, P O Mulder, A S Dofferhoff, R J van Thiel, H Plijter-Groendijk, J Korf
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引用次数: 0

摘要

我们描述了使用皮下微透析连续采样乳酸监测血浆乳酸浓度在8例患者休克。透析液乳酸浓度与血浆乳酸浓度呈显著相关(r = 0.8229),但患者间线性回归线存在差异。因此,我们使用每个患者的单独回归线进行校准,以计算透析液浓度的估计血浆值。预测值与血浆乳酸值呈线性相关(r = 0.912), 95%置信区间为+/- 2.8 mmol/L。因此,皮下微透析不能准确估计血浆乳酸浓度。8例患者中有3例透析液/血浆乳酸比值与血浆乳酸浓度呈显著负相关。这表明,除了血浆乳酸,其他因素,如皮下脂肪组织代谢和血流,也可能影响皮下取样和透析液乳酸浓度。虽然微透析可用于在线采样和连续监测细胞外物质的浓度,但为了监测血浆乳酸,应设计允许血管内放置的采样探针。
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Lactate monitoring with subcutaneous microdialysis in patients with shock: a pilot study.

We describe the use of subcutaneous microdialysis for continuous sampling of lactate to monitor the plasma lactate concentration in eight patients with shock. The dialysate lactate concentrations were significantly correlated with the plasma lactate concentrations (r = 0.8229), but the linear regression lines varied between patients. Therefore, we used the individual regression line of each patient for calibration to calculate estimated plasma values from the dialysate concentrations. While the estimated values were linearly correlated to the plasma lactate values (r = 0.912), the 95% confidence interval of the estimated values was +/- 2.8 mmol/L. Thus, subcutaneous microdialysis does not allow accurate estimation of the plasma lactate concentration. In 3 of the 8 patients, there was a significant negative correlation between the dialysate/plasma lactate ratio and the plasma lactate concentration. This suggests that besides plasma lactate, other factors such as subcutaneous adipose tissue metabolism and blood flow, may influence subcutaneous sampling and dialysate lactate concentration as well. While microdialysis can be used for on-line sampling and continuous monitoring of the concentration of extracellular substances, for the purpose of plasma lactate monitoring, sampling probes should be designed that permit intravascular placement.

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