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血乳酸水平和乳酸清除率作为新生儿败血症死亡率的预测指标。

Blood Lactate Levels And Lactate Clearance As Predictors Of Mortality In Neonatal Sepsis.

机构信息

The children Hospital Lahore.

The Children's Hospital and Institute of Child Health, Lahore, Pakistan.

出版信息

J Ayub Med Coll Abbottabad. 2022 Jul-Sep;34(3):438-441. doi: 10.55519/JAMC-03-9087.

Abstract

BACKGROUND

Sepsis is life-threatening organ dysfunction caused by dysregulated host response to infection. Aim of the study is Neonatal sepsis refers to infection involving the blood stream in neonates. It is major health problem causing neonatal mortality and morbidity in developing countries. Our study aimed to assess the correlation between lactate clearance and blood lactate levels with outcome of neonatal sepsis.

METHODS

Seventy-three eligible neonates recruited with convenience sampling technique. Study was conducted at the Neonatology department, The Children's Hospital & the Institute of Child Health, Lahore. After approval from institutional review board, and informed consent of parents/guardians, neonates with sepsis were selected through a present inclusion and exclusion criteria. Data was collected with the predetermined demographics, inflammatory markers and lactate levels.

RESULTS

This research revealed 37% (n=27) mortality rate among septic neonates who were having higher blood lactate levels and low lactate clearance at 6 hours of admission in nursery. Hence higher serum lactate levels and low lactate clearance (<10%) at 6 hours were significant predictors of poor outcome in septic neonates (p-Value, <0.05). The lactate level of neonates who could not survive was 5.68±1.22 as compared to who were discharged 4.11±1.14 (p-Value, <0.05).

CONCLUSIONS

Higher blood lactate levels and lactate clearance of less than 10% at 6 hours of admission in nursery are significant predictors of mortality in neonatal sepsis. Early lactate stabilization and sepsis management can improve the clinical outcomes.

摘要

背景

败血症是由宿主对感染的失调反应引起的危及生命的器官功能障碍。本研究的目的是新生儿败血症是指新生儿血液感染。它是发展中国家导致新生儿死亡和发病的主要健康问题。我们的研究旨在评估乳酸清除率和血乳酸水平与新生儿败血症结局的相关性。

方法

采用便利抽样技术招募了 73 名合格的新生儿。该研究在拉合尔儿童医院和儿童健康研究所的新生儿科进行。在获得机构审查委员会的批准和家长/监护人的知情同意后,通过现有的纳入和排除标准选择败血症新生儿。收集的数据包括预定的人口统计学、炎症标志物和乳酸水平。

结果

本研究显示,在入院后 6 小时在托儿所中具有较高血乳酸水平和低乳酸清除率的败血症新生儿的死亡率为 37%(n=27)。因此,入院后 6 小时血清乳酸水平较高和乳酸清除率<10%是败血症新生儿不良结局的显著预测因素(p 值<0.05)。无法存活的新生儿的乳酸水平为 5.68±1.22,而出院的新生儿为 4.11±1.14(p 值<0.05)。

结论

入院后 6 小时在托儿所中较高的血乳酸水平和<10%的乳酸清除率是新生儿败血症死亡的显著预测因素。早期乳酸稳定和败血症管理可以改善临床结局。

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