相关实验视频
Updated: Jun 11, 2026

11:53
Cecal Ligation Puncture Procedure
Published on: May 7, 2011
54.9K
儿童严重败血症患者的乳酸动态:从前性队列研究的见解
Tarek A Abdelaziz1, Nehad Ahmed Karam2, Weaam Ibrahim Ismail3
1Paediatric Department, Faculty of Medicine, Zagazig University, Zagazig city, Egypt. tareklatef43@gmail.com.
BMC pediatrics
|May 17, 2024
概括
在患有严重败血症的儿童中,监测乳酸水平至关重要. 住院六小时后较高的乳酸盐水平和较低的清除率显著预测了儿科重症监护病房的死亡率.
科学领域:
- 儿科重症监护医药 儿科重症监护医药
- 传染病 传染病 传染病
- 生物标志物和诊断仪器
背景情况:
- 败血症是感染引起的危及生命的器官功能障碍,与乳酸水平升高有关.
- 乳糖监测对于管理严重的败血症和改善患者的治疗结果至关重要.
- 儿童严重的败血症和败血性休克需要有效的预后指标.
研究的目的:
- 评估血乳酸盐水平与患有严重败血症或败血性休克的儿科患者的死亡率之间的关联.
- 为了确定初始和6小时乳酸测量和乳酸清除对死亡率的预测值.
- 为了确定乳酸水平和清除的最佳切断值,预测儿科重症监护室 (PICU) 死亡率.
主要方法:
- 在儿童重症监护病房 (PICU) 进行前性研究,使用国际儿科败血症共识会议的标准.
- 在入院时测量血乳酸盐水平 (Lac H0) 和6小时后 (Lac H6).
- 静态指数 (Lac H0,Lac H6) 和动态指数 (delta-lactate,6小时乳酸清除) 的计算.
主要成果:
- 该研究包括46名儿童;整体死亡率为54.3%.
- 最初的乳酸盐水平 (Lac H0) 在幸存者和非幸存者之间没有差异.
- 与非幸存者相比,幸存者表现出明显较低的Lac H6,更高的三角乳酸盐和更高的6小时乳酸盐清除率.
- 乳酸清除率低于10%和Lac H6水平≥4 mmol/L与增加的PICU死亡率显著相关.
结论:
- 随着时间的推移,乳酸水平的趋势是儿科严重败血症和败血症休克死亡率的重要预测因素.
- 在住院6小时后乳酸水平升高和乳酸清除率降低与较高的死亡率有关.
- 动态乳酸监测为患有败血症的重症儿童提供了有价值的预后信息.
相关概念视频
Pharmacokinetics in Pediatric Patients: Overview and Drug Absorption
Understanding the physiological differences in the pediatric population is crucial for effective pharmacotherapy. Neonates, infants, and children exhibit significant variations in gastric pH, gastric emptying time, intestinal transit time, and biliary function. These variations profoundly affect oral drug absorption, necessitating a nuanced approach to pediatric dosing.Neonates present with a unique physiological profile, having a gastric pH greater than 4 and faster and more irregular gastric...
Pharmacokinetics in Pediatric Patients: Drug Distribution
Drug distribution in the pediatric population exhibits unique challenges and considerations due to the physiological differences between children, particularly neonates and infants, and adults. A crucial aspect of pediatric pharmacology is understanding how these differences impact the pharmacokinetics of various drugs, necessitating age-specific dosing strategies to ensure efficacy and safety.Neonates and infants have a higher total body water content, ~75%–90% of their body weight, compared...
Pharmacokinetics in Pediatric Patients: Drug Metabolism
In pediatric care, understanding the nuances of hepatic drug metabolism is crucial, as it significantly differs from that of adults. This divergence is primarily due to the developmental stage of drug-metabolizing enzymes, which affects how medications are processed in the body. In neonates, for instance, the activity of Phase I enzymes—critical for the initial breakdown of drugs—is markedly reduced, functioning at just 20–40% of the levels seen in adults. This reduction poses a challenge in...
Diabetic Ketoacidosis l: Introduction
DefinitionDiabetic ketoacidosis (DKA) is an acute, life-threatening complication of diabetes mellitus, characterized by a triad of hyperglycemia (blood glucose >250 mg/dL), ketonemia or ketonuria, and metabolic acidosis (arterial pH <7.30 and serum bicarbonate <18 mEq/L). It results from insulin deficiency combined with elevated levels of counterregulatory hormones—glucagon, catecholamines, cortisol, and growth hormone—leading to increased lipolysis, hepatic ketone production, and...
Diabetic Ketoacidosis ll: Pathophysiology
Diabetic ketoacidosis (DKA) is a metabolic emergency characterized by hyperglycemia, ketonemia, and metabolic acidosis. It results from severe insulin deficiency and an excess of counterregulatory hormones, leading to uncontrolled lipolysis, ketogenesis, and widespread electrolyte and fluid disturbances.Pathophysiology The central event in DKA is a profound loss of insulin action. Without insulin, glucose uptake in insulin-dependent tissues is impaired, while hepatic glucose production...

