Clinical significance of early lactate clearance on prognosis in patients with hemorrhagic hypo volemic shock

doi:10.3877/cma.j.issn.1674-0793.2010.04.010

Abstract

Abstract:

Objective

To evaluate the correlation between the prognosis and the early lactate clearance in patients with hemorrhagic hypovolemic shock.

Methods

Prospective observation and collecting the data of 92 patients with hemorrhagic hypovolemic shock. APACHE II score, the mortality and the lactate clearance after 6hours were measured. The patients were analyzed with respect to survival and nonsurvival, low lactate clearance and high lactate clearance.

Results

There was no statistical difference between the two groups in age, sex, APACHE II score and the baseline of lactate. The early lactate clearance in survival group was significantly more than that in the nonsurvival group, (29.8±15.2)% vs (9.8±9.1)%, P<0.01. The mortality was in high lactate clearance group significantly less than that in the low lactate group, 11.3% vs 42.9%, P<0.01.

Conclusion

The early lactate clearance is a good prognostic factor of hemorrhagic hypovolemic shock.

Key words: Hypovolemic shock, Lactate clearance

Jian-feng WU, Xiang-dong GUAN, Juan CHEN, Bin OUYANG, Ming-ying CHEN, Shun-wei HUANG. Clinical significance of early lactate clearance on prognosis in patients with hemorrhagic hypo volemic shock[J]. Chinese Archives of General Surgery(Electronic Edition), 2010, 04(04): 332-335.

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References 13

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?	年龄（岁）	性别（男/女）	APACHEⅡ	血乳酸基础值(h)	后血乳酸值(h)	乳酸清除率(%)
存活组(75例)	61.2±16.3	52/23	19.7±7.2	5.2±2.9	3.6±1.1	29.8±15.2
死亡组(17例)	60.1±22.5	12/5	20.1±9.6	6.1±3.3	5.4±2.1	9.8±9.1
P值	0.448	0.261	0.198	0.066	<0.001	0.002

?	年龄（岁）	性别（男/女）	APACHEⅡ	血乳酸基础值(h)	后血乳酸值(h)	乳酸清除率(%)
存活组(75例)	61.2±16.3	52/23	19.7±7.2	5.2±2.9	3.6±1.1	29.8±15.2
死亡组(17例)	60.1±22.5	12/5	20.1±9.6	6.1±3.3	5.4±2.1	9.8±9.1
P值	0.448	0.261	0.198	0.066	<0.001	0.002

项目	高乳酸清除率组(n=71)	低乳酸清除率组(n=21)	P值
年龄（岁）	59.2±13.7	61.1±27.5	0.092
性别（男/女）	50/21	14/7	0.215
Hb基础值(g/L)	88.3±10.7	86.1±17.1	0.117
升压药使用比例(%)	40.8%	42.9%	0.251
呼吸机使用比例(%)	52.1%	57.1%	0.142
APACHEⅡ	19.1±9.1	19.9±13.2	0.103
血乳酸基础值(mmol/L)	5.5±2.1	6.0±2.9	0.088
病死率(%)（死亡/存活）	11.3(8/71)	42.9(9/21)	<0.001

项目	高乳酸清除率组(n=71)	低乳酸清除率组(n=21)	P值
年龄（岁）	59.2±13.7	61.1±27.5	0.092
性别（男/女）	50/21	14/7	0.215
Hb基础值(g/L)	88.3±10.7	86.1±17.1	0.117
升压药使用比例(%)	40.8%	42.9%	0.251
呼吸机使用比例(%)	52.1%	57.1%	0.142
APACHEⅡ	19.1±9.1	19.9±13.2	0.103
血乳酸基础值(mmol/L)	5.5±2.1	6.0±2.9	0.088
病死率(%)（死亡/存活）	11.3(8/71)	42.9(9/21)	<0.001

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[3]	Ting Wang, Haiming Li, Hongmei Li. Value of 6-hour lactate clearance rate combined with NT-proBNP and albumin detection in prognostic evaluation of elderly patients with severe pneumonia [J]. Chinese Journal of Clinicians(Electronic Edition), 2021, 15(12): 954-959.
[4]	Jingjing Wu, Ming Sun, Xueshan Wang, Deguang Chen. Combination of intraosseous infusion and deep vein catheterization for treatment of hypovolemic shock patients in emergency department [J]. Chinese Journal of Hygiene Rescue(Electronic Edition), 2018, 04(04): 217-220.

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