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红细胞分布宽度与血清乳酸变化趋势作为脓毒症和脓毒性休克预后因素的相关性

Correlation of the changing trends of red cell distribution width and serum lactate as a prognostic factor in sepsis and septic shock.

作者信息

Gupta Mukesh K, Yadav Ghanshyam, Singh Yashpal, Bhalekar Arvind

机构信息

Department of Anaesthesiology, IMS, BHU, Varanasi, Uttar Pradesh, India.

出版信息

J Anaesthesiol Clin Pharmacol. 2020 Oct-Dec;36(4):531-534. doi: 10.4103/joacp.JOACP_105_19. Epub 2021 Jan 18.

Abstract

BACKGROUND AND AIMS

Various biomarkers are used for predicting outcome from sepsis and septic shock but single value doesn't give clear-cut picture. Changing trends of serum lactate and red cell distribution width (RDW) gives more accurate information of patient outcome. So, aim of this prospective observational study was to identify the correlation, for initial and changing trend of blood lactate level and RDW, with 28-day mortality in sepsis and septic shock.

MATERIAL AND METHODS

Patient who fulfills the criteria of sepsis and septic shock, according to the consensus conference published in 2016, were included in this study. All patients were resuscitated and managed according to institutional protocol for sepsis and septic shock. Serum lactate and RDW was obtained from arterial blood gas and complete blood count, respectively. Serum lactate and RDW were recorded at 0 h, 6 h, 24 h, day 2, day 3, day 7, week 2, and week 3. Mean between two groups were compared with student t-test. Pearson and Spearman correlation coefficient was used for establishing correlation between two continuous data. value < 0.05 indicates significant difference between two groups.

RESULTS

There is positive correlation between serum lactate and RDW at all-time point in non-survival group while negative correlation was found in survival group except on day1 and 2.

CONCLUSION

Changing trends of serum lactate and RDW can be used as a prognostic marker in patient of sepsis and septic shock.

摘要

背景与目的

多种生物标志物用于预测脓毒症和脓毒性休克的预后,但单一数值并不能提供清晰的情况。血清乳酸和红细胞分布宽度(RDW)的变化趋势能提供关于患者预后更准确的信息。因此,这项前瞻性观察性研究的目的是确定血乳酸水平和RDW的初始值及变化趋势与脓毒症和脓毒性休克患者28天死亡率之间的相关性。

材料与方法

根据2016年发表的共识会议标准,符合脓毒症和脓毒性休克标准的患者纳入本研究。所有患者均按照机构的脓毒症和脓毒性休克治疗方案进行复苏和管理。血清乳酸和RDW分别从动脉血气和全血细胞计数中获取。在0小时、6小时、24小时、第2天、第3天、第7天、第2周和第3周记录血清乳酸和RDW。两组均值比较采用学生t检验。Pearson和Spearman相关系数用于建立两个连续数据之间的相关性。P值<0.05表示两组之间存在显著差异。

结果

在非存活组中,血清乳酸和RDW在所有时间点均呈正相关,而在存活组中,除第1天和第2天外呈负相关。

结论

血清乳酸和RDW的变化趋势可作为脓毒症和脓毒性休克患者的预后标志物。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/51fe/8022044/9e395b663a02/JOACP-36-531-g001.jpg

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