乳酸盐升高与糖尿病酸性脂肪酸症成人临床结果之间的关联
Aashish Kumar1, Ra'eesa Doola2, Amanda Zahumensky3
1Intensive Care Unit, Logan Hospital, Queensland, Brisbane, Australia.
Journal of critical care
|July 21, 2023
概括
患有糖尿病酸症 (DKA) 的ICU患者的高乳酸血症与增加的住院死亡率和更长的住院时间有关. 这一发现在2型糖尿病患者中尤为突出,突出了关键的危险因素.
科学领域:
- 关键护理医学 关键护理医学
- 内分泌学 在内分泌学.
- 代谢障碍 代谢障碍 代谢障碍
背景情况:
- 糖尿病酸症 (DKA) 是糖尿病的一种严重并发症,需要密集护理.
- 超乳酸血症,乳酸水平升高,是已知的危急疾病标志物.
- 需要进一步阐明在ICU环境中的DKA患者中高乳糖血症的预后意义.
研究的目的:
- 为了确定在重症监护室 (ICU) 诊断为糖尿病酸症 (DKA) 的患者中超乳酸血症的发生率.
- 评估超乳糖血症对DKA患者住院死亡率和其他重症监护结果的影响.
主要方法:
- 进行了一项回顾性多中心队列研究,使用澳大利亚和新西兰DKA.患者入院ICU的成年患者的数据.
- 患者被分为正常乳酸血症 (乳酸盐<2.0 mmol/L) 和高乳酸血症 (乳酸盐≥2.0 mmol/L) 组.
- 住院死亡率是主要结局,次要结局包括ICU/住院时间,机械呼吸,脏替代疗法 (RRT) 和异能药物使用.
主要成果:
- 这项研究包括9061名DKA患者. 超乳糖血症与增加的住院死亡率 (OR1.785,p=0.014) 有意义地相关.
- 乳酸水平升高与较长的医院LOS (GMR 1.063,p=0.001) 和ICU LOS (GMR 1.057,p<0.001) 相相关.
- 超乳糖血症也与较高的RRT率 (OR 2.198,p<0.001) 和内使用 (OR 1.578,p<0.001) 相关,特别是在2型糖尿病患者中.
结论:
- 乳糖过高是DKA的ICU患者不良结果的重要预测因素.
- 超乳糖血症的存在需要警监测和管理,因为它与较高的死亡率和资源利用率有关.
- 这些发现强调了乳酸水平评估在DKA管理中的重要性,特别是在2型糖尿病中.
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