Iraí Láscarez-LAGUNAS2, Carlos Sánchez-GASCA2, Laura Láscarez-LAGUNAS3, Eugenio García- CANO, Eduardo Gómez-CONDE, Mario García-CARRASCO, María Eugenia GUERRERO-FERNÁN- DEZ, Álvaro Montiel JARQUÍN, Aurelio López COLOMBO

Lactate clearance is a prognostic factor in patients on shock state

Çalışmanın amacı laktat klirensinin şok durumundaki hastalarda mortalite prognostik faktörü olarak bir değerinin olup olmadığını değerlendirmektir. Bu çalışma 19 yaşından büyük hastalarda kronik hastalıklar, hepatik yetmezlik, kanserler ve biguanid tedavisi kullanan diyabetik hastalar dışlanarak yapılan açıklayıcı ileriye dönük, homodemik bir çalışma olarak yapıldı. Laktat klirensi ve aynı zamanda başvuruda, 6, 12 ve 24. saatlerde laktat oranlarını ölçmek için arteryal gazometre kullanıldı. Hayatta kalan ve ölenlerin bulguları ve APACHE IIleri arasındaki korelasyon karşılaştırıldı. Kırk bir hasta çalışmaya alındı. %53.7si kadın, %46.3ü erkekti, yaş ortalaması 69.95 yıl idi. Tanılar %29.2 hastada septik şok, %63.4 hastada hipovolemik ve %7.3 hastada kardiyojenik şoktu.Kardiyojenik şokta mortalite sıfır laktak klirensle birlikte %100 idi. Laktat klirensi gibi survival oranları hipovolemik şokta daha yüksek idi (12 ve 24. saatlerde). 24 saatte odan küçük laktat klirens oranları pozitif prediktif değere ve %80 sensitiviteye sahipti. Univariate analizde, 6, 12 ve 24. saatlerde yaşayanlarda ölenler arasında laktat klirensinde istatistiksel anlamlılık tes- pit edildi (sırasıyla, p

Laktat klirensi şok durumundaki hastalarda bir prognostik faktördür

Aim is to determine whether lactate clearance has value as mortality prognostic factor in shock patients, or not. A scrutiny, descriptive, prolective, homodemic, longitudinal study in patients older than 19 years, excluding chronic renal illness, hepatic insufficiency, neoplasias and diabetics on biguanides treatment, was performed. Arterial gasometry was used to obtain lactate rates at admission, 6, 12, and 24 hours as well as lactate s clearance. Determinations between survivors and not survivors were compared, as well as correlation with APACHE II was performed. 41 patients were studied, 53.7% women and 46.3% men, mean age was 63.95 years. The diagnostics were septic shock in 29.2%, hypovolemic 63.4%, and cardiogenic 7.3%. The mortality in car- diogenic shock was 100%, with null lactate clearance. The survival rate was higher in hypovolemic shock as its lactate clearance rates (at 12 and 24 hours). Lactate clearance rates of less than 0 at 24 hours had a positive predictive value and a sensitivity of 80%. Lactate clearance at 6, 12, 24 hours among survivors and not survivors demonstrated statistical significance in the Univariate Analysis (p

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