预测重症监护病房死亡率:血清乳酸盐的兴趣
Chihebeddine Ben Maaouia1, Faten Haddad1, Asma Ben Souissi1
1Department of Anesthesia and Intensive Care, Mongi Slim University Hospital, Tunis/ Faculty of Medicine of Tunis- University of Tunis El Manar, Tunis, Tunisia.
La Tunisie medicale
|February 19, 2024
概括
入院乳酸水平对于预测重症监护室 (ICU) 死亡率有价值. 入院时乳酸水平升高可独立预测死亡,有助于风险识别和治疗评估.
科学领域:
- 关键护理医学 关键护理医学
- 生物化学 生物化学
- 预测生物标志物 预测生物标志物
背景情况:
- 现有的重症监护室 (ICU) 死亡率的预后指数缺乏完美的准确性.
- 需要可靠的生物标志物来评估患者状况并预测ICU中的结果.
研究的目的:
- 为了评估动脉血液乳酸盐 (ABL) 水平在ICU入院时的预后意义.
- 确定ABL是否可以预测重症患者的死亡率.
主要方法:
- 一项前性,观察性队列研究,涉及135名ICU患者在12个月内.
- 静脉血液中的乳酸盐 (ABL) 在入院后被测量为序列 (H0,H6,H12,H24,H48).
- 记录了预后得分,生物数据和血液动力学参数;ICU死亡率是主要终点.
主要成果:
- 在ICU的死亡率为48%. 平均吸收ABL为3.05±2.63毫摩尔/升,在未幸存者中显著更高.
- 摄入乳酸盐显示出良好的预后值 (AUC>0.7),确定了关键的"切断值".
- 初始乳糖 > 2 mmol/l 是ICU死亡率的独立预测因子 (OR [95% CI] = 1.16 [1.073.6]; p=0.04).
结论:
- 在ICU中的乳酸监测有助于识别高风险患者.
- 序列乳酸测量可以帮助重新评估重症患者的治疗疗效.
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