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静脉注射甘油引起的高乳酸血症:一例病例研究。

Hyperlactatemia caused by intra-venous administration of glycerol: A case study.

作者信息

Katayama Shinshu, Nunomiya Shin, Wada Masahiko, Misawa Kazuhide, Tanaka Shinichiro, Koyama Kansuke, Koinuma Toshitaka

机构信息

Department of Emergency Medicine, Asahi General Hospital, Chiba, Japan.

出版信息

Indian J Crit Care Med. 2012 Oct;16(4):241-4. doi: 10.4103/0972-5229.106514.

Abstract

Glyceol(®) is an intracranial pressure reducing agent composed of 5% fructose and concentrated glycerol. Although rapid administration of fructose is known to cause lactic acidosis, little is known about hyperlactatemia caused by Glyceol(®) administration itself in adults. We observed an adult case of hyperlactatemia occurred after administration of 200 mL of Glyceol(®) over a period of 30 minutes. Since there was no evidence of an underlying liver disease or metabolic abnormality, and no findings of sepsis or impaired tissue perfusion, the cause of this condition was deemed to be the rapid loading of fructose contained as a constituent of Glyceol(®). We then performed a retrospective chart review and found other 9 cases admitted to Jichi Medical University Hospital ICU and administered Glyceol(®) during the past year. Their lactate levels increased in general, peaked approximately 45 minutes after Glyceol(®) administration and returned to pre-administration levels around 3 hours after. Although hyperlactatemia is an important indicator of sepsis and impaired tissue perfusion, caution is required when performing such an assessment in patients being administered Glyceol(®).

摘要

甘油果糖(Glyceol®)是一种由5%果糖和浓缩甘油组成的降颅内压药物。虽然已知快速输注果糖会导致乳酸性酸中毒,但关于在成人中甘油果糖(Glyceol®)给药本身引起的高乳酸血症却知之甚少。我们观察到1例成人在30分钟内输注200 mL甘油果糖(Glyceol®)后发生了高乳酸血症。由于没有潜在肝脏疾病或代谢异常的证据,也没有脓毒症或组织灌注受损的表现,所以认为这种情况的原因是甘油果糖(Glyceol®)成分中果糖的快速输注。然后我们进行了一项回顾性病历审查,发现过去一年内在埼玉医科大学附属医院重症监护病房住院并接受甘油果糖(Glyceol®)治疗的其他9例患者。他们的乳酸水平总体上升,在甘油果糖(Glyceol®)给药后约45分钟达到峰值,并在给药后约3小时恢复到给药前水平。虽然高乳酸血症是脓毒症和组织灌注受损的重要指标,但在对接受甘油果糖(Glyceol®)治疗的患者进行此类评估时需要谨慎。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d1db/3610464/51a4e03a20bb/IJCCM-16-241-g002.jpg

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