Trebuian Cosmin Iosif, Brici Octavia Maria, Sutoi Dumitru, Popa Daian Ionel, Chioibas Daniel Raul, Mederle Ovidiu Alexandru
Department of Surgery I, "Victor Babes" University of Medicine and Pharmacy, E. Murgu Square No. 2, 300041 Timisoara, Romania.
Department of Doctoral Studies, "Victor Babes" University of Medicine and Pharmacy, E. Murgu Square No. 2, 300041 Timisoara, Romania.
Clin Pract. 2024 May 9;14(3):834-845. doi: 10.3390/clinpract14030065.
This investigation assesses the prognostic value of lactate levels and their clearance in septic shock patients, particularly emphasizing the comparative analysis between COVID-19 and non-COVID-19 patients in the emergency department. This study aims to elucidate the unique prognostic implications of lactate dynamics in these distinct patient groups, thereby enhancing the management of septic shock.
An observational prospective study was conducted, enrolling 114 septic shock patients from the Emergency County Hospital Resita, Romania, categorizing them into COVID-19 and non-COVID-19 groups to examine their initial lactate levels, clearance rates, and their correlation with patient outcomes.
This study identified significant differences in the initial lactate levels and clearance rates between the two groups, indicating higher initial lactate levels and slower clearance rates in COVID-19 patients. Survivors demonstrated significantly lower initial lactate levels (1.5 ± 0.4 mmol/L) and higher lactate clearance rates (33 ± 15%) compared to non-survivors (2.5 ± 0.5 mmol/L and 24 ± 9%, respectively; lactate levels = 0.001, clearance rates = 0.002).
Lactate monitoring, particularly clearance rates, is crucial in the prognostic assessment of septic shock patients. These findings highlight the need for targeted interventions in COVID-19 patients to improve outcomes, underscoring lactate dynamics as a vital component of septic shock management in differing patient populations.
本研究评估乳酸水平及其清除率在感染性休克患者中的预后价值，特别强调急诊科中新型冠状病毒肺炎（COVID-19）患者与非COVID-19患者之间的对比分析。本研究旨在阐明乳酸动力学在这些不同患者群体中的独特预后意义，从而加强感染性休克的管理。
进行了一项观察性前瞻性研究，纳入了罗马尼亚雷希察县急诊医院的114例感染性休克患者，将他们分为COVID-19组和非COVID-19组，以检查他们的初始乳酸水平、清除率及其与患者预后的相关性。
本研究发现两组患者的初始乳酸水平和清除率存在显著差异，表明COVID-19患者的初始乳酸水平更高，清除率更低。与非幸存者相比，幸存者的初始乳酸水平显著更低（1.5±0.4 mmol/L），乳酸清除率更高（分别为33±15%和24±9%；乳酸水平P = 0.001，清除率P = 0.002）。
乳酸监测，尤其是清除率，在感染性休克患者的预后评估中至关重要。这些发现凸显了对COVID-19患者进行针对性干预以改善预后的必要性，强调了乳酸动力学作为不同患者群体感染性休克管理的重要组成部分。
