Markers of tissue hypoperfusion in pediatric septic shock.
Markers of tissue hypoperfusion in pediatric septic shock.
复制标题
小儿败血性休克中组织灌注不足的标记。
DOI：
10.1007/s001340050015
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发表时间：
2000-01
影响因子：
38.9
通讯作者：
Lambert M
中科院分区：
文献类型：
--
作者：
Dugas MA;Proulx F;de Jaeger A;Lacroix J;Lambert M
目的：描述感染性休克危重儿童的整体氧合参数、内脏灌注不足标志物以及与细胞能量产生相关的代谢活动的测量结果。¶设计：一系列病例的临床研究。¶患者和参与者：11 名入住大学医院儿科重症监护病房 (ICU) 的既往健康的感染性休克儿童。¶干预措施：无。¶测量和结果：耗氧量、氧输送 (DO2)、血清碳酸氢盐、入院后0、6、12、24、36和48小时连续测量动脉pH、胃粘膜内pH（pHi）、胃动脉二氧化碳张力梯度、血清乳酸、丙酮酸、乳酸与丙酮酸比值（L/P）、酮体比值以及酯化与游离肉碱比值。所有的孩子都活了下来。一名患者未能表现出 DO2 超正常（> 570 ml/min/m2）。血清碳酸氢盐和乳酸的正常化与患者的康复相关。一名患者的 L/P 比率日益异常，但乳酸水平正常，表明丙酮酸的利用增加，而不是细胞质氧化还原电位增加。尽管在 43% 的样本中观察到胃部 pHi 值 < 7.30，但个体的连续测量显示出显着的变异性和不可预测的趋势。游离脂肪酸浓度、酮体生成和肉碱水平保持在正常范围内。¶结论：在这项研究中，血清碳酸氢盐和乳酸的趋势在一定程度上表征了感染性休克儿童的恢复情况。根据我们的数据，尚不清楚其他标志物如何用于修改治疗。
Objective: To describe measurements of global oxygenation parameters, markers of splanchnic hypoperfusion and those of metabolic activity related to cellular energy production among critically ill children with septic shock.¶Design: Clinical study of a series of cases.¶Patients and participants: 11 previously healthy children with septic shock admitted to the pediatric intensive care unit (ICU) of a university hospital.¶Interventions: None.¶Measurements and results: Oxygen consumption, oxygen delivery (DO2), serum bicarbonate, arterial pH, gastric intramucosal pH (pHi), gastroarterial carbon dioxide tension gradient, serum lactate, pyruvate, lactate to pyruvate ratio (L/P), ketone body ratio, and the esterified to free carnitine ratio were measured serially at 0, 6, 12, 24, 36, and 48 h after admission to the pediatric ICU. All children survived. One patient failed to show supranormal DO2 ( > 570 ml/min per m2). Normalization of serum bicarbonate and lactate were associated with patient recovery. One patient presented an increasingly abnormal L/P ratio with normal lactate levels, suggesting an increased utilization of pyruvate rather than an increased cytosolic redox potential. Although values of gastric pHi < 7.30 were observed in 43 % of samples, serial measurements in individuals showed significant variability and unpredictable trends. Free fatty acid concentrations, ketone body production, and carnitine levels remained within the normal range.¶Conclusions: In this study, trends in serum bicarbonate and lactate somewhat characterized the recovery of children with septic shock. Based on our data, it is unclear how other markers may have been used to modify therapy.
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影响因子：
3.6
作者：
Proulx, F;Lacroix, J;Lambert, M
通讯作者：
Lambert, M
影响因子：
8.8
作者：
POLLACK, MM;FIELDS, AI;RUTTIMANN, UE
通讯作者：
RUTTIMANN, UE
影响因子：
8.8
作者：
Casado-Flores, J;Mora, E;Ruiz-López, MJ
通讯作者：
Ruiz-López, MJ
影响因子：
120.7
作者：
HOTCHKISS, RS;KARL, IE
通讯作者：
KARL, IE
影响因子：
9.6
作者：
KRAFTEJACOBS, B;CARVER, J;WILKINSON, JD
通讯作者：
WILKINSON, JD