连续性血液净化对重症脓毒症患者血乳酸水平及6h乳酸清除率的影响

被引:12
作者
李跃东 [1 ,2 ]
王锦权 [1 ]
邵敏 [1 ]
机构
[1] 安徽医科大学附属省立医院ICU
[2] 中国人民解放军医院ICU
关键词
重症脓毒症; 血乳酸; 6 h乳酸清除率; 连续性血液净化; 预后;
D O I
10.19405/j.cnki.issn1000-1492.2014.02.029
中图分类号
R459.7 [急症、急救处理];
学科分类号
100231 [临床病理学];
摘要
目的探讨连续性血液净化对重症脓毒症患者的血乳酸水平及6 h乳酸清除率的影响。方法本研究为前瞻性随机对照研究。48例重症脓毒症患者随机分为常规治疗组(对照组)和连续性血液净化组(CBP组),入重症医学科(ICU)时检测其动脉血乳酸水平,并在6、24、48、72 h时间点复检,计算出该患者6 h血乳酸清除率;并记录相应时间点的急性生理和慢性健康状态评分(APACHEⅡ评分)。比较两组间血乳酸水平、6 h乳酸清除率、APACHEⅡ评分的变化;比较两组患者住ICU时间以及28 d病死率。结果与对照组比较,CBP组患者各时间点的APACHEⅡ评分和血乳酸水平降低明显,6 h乳酸清除率明显增加,ICU住院时间明显缩短,差异均有统计学意义(P<0.05);28 d病死率有降低趋势,但差异无统计学意义。结论重症脓毒症患者,CBP治疗能有效降低血乳酸水平,减轻病情的严重程度,缩短ICU住院时间。
引用
收藏
页码:251 / 253+257 +257
页数:4
相关论文
共 10 条
[1]
Effect of sodium bicarbonate administration on mortality in patients with lactic acidosis: a retrospective analysis..[J].Hyun Jeong Kim;Young Ki Son;Won Suk An.PLoS ONE.2017, 6
[2]
Lactate clearance for death prediction in severe sepsis or septic shock patients during the first 24 hours in Intensive Care Unit: an observational study [J].
Marty, Philippe ;
Roquilly, Antoine ;
Vallee, Fabrice ;
Luzi, Aymeric ;
Ferre, Fabrice ;
Fourcade, Olivier ;
Asehnoune, Karim ;
Minville, Vincent .
ANNALS OF INTENSIVE CARE, 2013, 3 :1-7
[3]
Early interventions in severe sepsis and septic shock: a review of the evidence one decade later [J].
Rivers, E. P. ;
Katranji, M. ;
Jaehne, K. A. ;
Brown, S. ;
Abou Dagher, G. ;
Cannon, C. ;
Coba, V. .
MINERVA ANESTESIOLOGICA, 2012, 78 (06) :712-724
[4]
Bench-to-bedside review: Vasopressin in the management of septic shock [J].
Russell, James A. .
CRITICAL CARE, 2011, 15 (04)
[5]
Sepsis Bundles and Compliance With Clinical Guidelines.[J].Lisa Stoneking.Journal of Intensive Care Medicine.2011, 3
[6]
The impacts of continuous veno-venous hemofiltration on plasma cytokines and monocyte human leukocyte antigen-DR expression in septic patients [J].
Zhang Peng ;
Peng Pai ;
Liu Hong-Bao ;
Li Rong ;
Wang Han-Min ;
Huang Chen .
CYTOKINE, 2010, 50 (02) :186-191
[7]
MULTICENTER STUDY OF EARLY LACTATE CLEARANCE AS A DETERMINANT OF SURVIVAL IN PATIENTS WITH PRESUMED SEPSIS [J].
Arnold, Ryan C. ;
Shapiro, Nathan I. ;
Jones, Alan E. ;
Schorr, Christa ;
Pope, Jennifer ;
Casner, Elisabeth ;
Parrillo, Joseph E. ;
Dellinger, R. Phillip ;
Trzeciak, Stephen .
SHOCK, 2009, 32 (01) :35-39
[8]
Early lactate clearance is associated with improved outcome in severe sepsis and septic shock [J].
Nguyen, HB ;
Rivers, EP ;
Knoblich, BP ;
Jacobsen, G ;
Muzzin, A ;
Ressler, JA ;
Tomlanovich, MC .
CRITICAL CARE MEDICINE, 2004, 32 (08) :1637-1642
[9]
2001 SCCM/ESICM/ACCP/ATS/SIS International Sepsis Definitions Conference [J].
Levy, MM ;
Fink, MP ;
Marshall, JC ;
Abraham, E ;
Angus, D ;
Cook, D ;
Cohen, J ;
Opal, SM ;
Vincent, JL ;
Ramsay, G .
CRITICAL CARE MEDICINE, 2003, 31 (04) :1250-1256
[10]
High-volume haemofiltration in human septic shock [J].
Cole, L ;
Bellomo, R ;
Journois, D ;
Davenport, P ;
Baldwin, I ;
Tipping, P .
INTENSIVE CARE MEDICINE, 2001, 27 (06) :978-986