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一氧化碳中毒患者初始乳酸的价值:在急诊科。

The value of initial lactate in patients with carbon monoxide intoxication: in the emergency department.

机构信息

Department of Emergency Medicine, Chonnam National University Hospital, Gwangju, South Korea.

出版信息

Hum Exp Toxicol. 2011 Aug;30(8):836-43. doi: 10.1177/0960327110384527. Epub 2010 Sep 27.

Abstract

Patients with carbon monoxide (CO) poisoning have been found to have a correlation between initial clinical severity on admission and blood lactate levels. Recently, it is suggested that the lactate level may be a useful prognostic factor in cases study. The purpose of this study was to determine whether lactate levels were associated with the short-term outcome of patients with CO poisoning and identify the characteristics of patients with high initial lactate levels. Eighty patients that presented to the Chonnam National University Hospital after CO poisoning, over 5 years, were enrolled in this retrospective study. Fifty-six (70.0%) patients had high lactate (>2.1 mmo/L) on admission. Thirty-three (41.3%) patients had medical complications and one patient (1.3%) died. The patients with high initial lactate had an altered mental status more frequently, higher WBC, glucose and carboxyhemoglobin (COHb), and lower base deficit on admission. The multivariate analysis showed that lactate was an independent factor associated with serious complications and the need for intensive medical treatment, along with advanced age, WBC, and altered mental status on admission. The results of this study show that the initial lactate was useful for patient prognosis after CO poisoning.

摘要

一氧化碳(CO)中毒患者入院时的初始临床严重程度与血乳酸水平之间存在相关性。最近,有研究表明乳酸水平可能是病例研究中有用的预后因素。本研究旨在确定乳酸水平是否与 CO 中毒患者的短期预后相关,并确定初始乳酸水平较高患者的特征。本回顾性研究纳入了 5 年来在全南国立大学医院就诊的 80 例 CO 中毒患者。56 例(70.0%)患者入院时乳酸水平较高(>2.1mmol/L)。33 例(41.3%)患者出现医疗并发症,1 例患者(1.3%)死亡。入院时初始乳酸水平较高的患者精神状态改变更频繁,白细胞计数(WBC)、血糖和碳氧血红蛋白(COHb)更高,碱缺失更低。多因素分析显示,入院时乳酸是与严重并发症和需要强化治疗相关的独立因素,此外还与年龄较大、WBC 计数较高和精神状态改变有关。本研究结果表明,初始乳酸对 CO 中毒患者的预后有一定的预测价值。

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