100 242

Cited 0 times in

The Usefulness of Lactate Clearance Adjusted to Time as a Predictive Index in Patients with Severe Sepsis and Septic Shock

Other Title
중증 패혈증 및 패혈성 쇼크 환자에서 예측 인자로서의 시간으로 보정한 젖산 청소율의 유용성
Authors
안, 정환; 최, 상천; 민, 영기; 정, 윤석; 정, 성희; 이, 영주
Citation
Taehan Chunghwanja Ŭihakhoe chi, 24(3):134-139, 2009
Journal Title
Taehan Chunghwanja Ŭihakhoe chi; Korean journal of critical care medicine; 대한중환자의학회지
ISSN
1229-48022234-3261
Abstract
Background: The lactate concentration should be used to examine the severity of sepsis or any state of shock. This study was conducted to investigate the prognostic power of the lactate clearance, as adjusted for time, between the survivors and nonsurvivors of patients with severe sepsis or septic shock.



Methods: The study was performed on 67 patients over 16 years old and who were admitted to the intensive care unit (ICU) with severe sepsis or septic shock. They were divided into the survivors (n = 37) and nonsurvivors (n = 30). The blood lactate concentrations were assayed at intervals ranging from 8 to 24 hours and the APACHE III scoring was done daily for 2 weeks or until discharge or death. The lactate clearance, as adjusted for time, was defined using the following formula: [(the maximal lactate concentration - the normal lactate concentration)/the time to normalize the lactate concentration] × 1,000.



Results: There were no significant differences of age, gender and the length of the ICU stay between the survivors and non-survivors. There were significant difference of the time to measuring the maximal serum lactate concentration (3.2 ± 12.3 hours vs. 28.8 ± 64.6 hours, respectively; p = 0.037), the lactate clearance, as adjusted for time (132.27 ± 112.88 mol/L · hour vs. 59.67 ± 72.60 mol/L · hour, respectively; p = 0.002), the lactate clearance during 24 hours (46.0 ± 26.3% vs. 22.6 ± 45.6%, respectively; p = 0.018) and the APACHE III score (67.6 ± 22.7 vs. 83.9 ± 21.6, respectively; p = 0.005) between the survivors and non-survivors. The lactate clearance, as adjusted for time and the APACHE III score were the predictive factors for survival on the logistic regression analysis (odd ratio 0.987; p = 0.028 vs. odd ratio 1.046; p = 0.006).



Conclusions: Lactate clearance, as adjusted for time, could be used as a prognostic index, as well as the APACHE III score, for patients with severe sepsis or septic shock.
Keywords
lactate clearanceprognostic implicationseptic shocksevere sepsis
Appears in Collections:
Journal Papers > School of Medicine / Graduate School of Medicine > Emergency Medicine
Journal Papers > School of Medicine / Graduate School of Medicine > Anesthesiology & Pain Medicine
AJOU Authors
안, 정환최, 상천민, 영기정, 윤석이, 영주
Full Text Link
Files in This Item:
134-139.pdfDownload
Export
RIS (EndNote)
XLS (Excel)
XML

qrcode

해당 아이템을 이메일로 공유하기 원하시면 인증을 거치시기 바랍니다.

Items in DSpace are protected by copyright, with all rights reserved, unless otherwise indicated.

Browse