Blood lactate as a predictor for in-hospital mortality in patients admitted acutely to hospital: a systematic review.
Blood lactate as a predictor for in-hospital mortality in patients admitted acutely to hospital: a systematic review.
复制标题
DOI：
10.1186/1757-7241-19-74
复制
发表时间：
2011-12-28
期刊：
影响因子：
--
通讯作者：
Barfod C
中科院分区：
文献类型：
--
作者：
Kruse O;Grunnet N;Barfod C
在危重患者中使用血乳酸监测进行风险评估仍然存在争议。一些差异是由于适当的参考区间的不确定性，以及是否在入院时进行单次乳酸盐测量作为筛选方法，或连续乳酸盐测量。此外，对于是否应从动脉血、外周静脉血或毛细血管血中抽取样本，也没有达成共识。本综述的目的是：1）检查血乳酸水平是否可预测急性环境中患者的院内死亡率，即在院前、创伤中心、急诊科或重症监护室评估的患者。2)检查急性环境中患者动脉、外周静脉和毛细血管血乳酸水平之间的一致性。我们使用PubMed、科克伦对照试验中心注册库、科克伦系统评价数据库和CINAHL进行了系统检索，检索时间截止到2011年4月。66篇文章被认为具有潜在相关性，并进行了全文评价，最终选择了其中的33篇文章。文献综述支持血乳酸监测对急性入院患者的风险评估是有用的，特别是通过连续乳酸采样获得的趋势，在预测住院死亡率方面是有价值的。所有入院时乳酸水平高于2.5 mM的患者应密切监测恶化迹象，但乳酸水平更低的患者应考虑进行连续乳酸监测。发现动脉血和静脉血中乳酸水平之间的相关性是可接受的，因此应鼓励静脉采样，因为该程序对患者的风险和不便最小。乳酸盐引导治疗的相关性必须得到更多研究的支持。
Using blood lactate monitoring for risk assessment in the critically ill patient remains controversial. Some of the discrepancy is due to uncertainty regarding the appropriate reference interval, and whether to perform a single lactate measurement as a screening method at admission to the hospital, or serial lactate measurements. Furthermore there is no consensus whether the sample should be drawn from arterial, peripheral venous, or capillary blood. The aim of this review was: 1) To examine whether blood lactate levels are predictive for in-hospital mortality in patients in the acute setting, i.e. patients assessed pre-hospitally, in the trauma centre, emergency department, or intensive care unit. 2) To examine the agreement between arterial, peripheral venous, and capillary blood lactate levels in patients in the acute setting. We performed a systematic search using PubMed, Cochrane Central Register of Controlled Trials, Cochrane Database of Systematic Reviews, and CINAHL up to April 2011. 66 articles were considered potentially relevant and evaluated in full text, of these ultimately 33 articles were selected. The literature reviewed supported blood lactate monitoring as being useful for risk assessment in patients admitted acutely to hospital, and especially the trend, achieved by serial lactate sampling, is valuable in predicting in-hospital mortality. All patients with a lactate at admission above 2.5 mM should be closely monitored for signs of deterioration, but patients with even lower lactate levels should be considered for serial lactate monitoring. The correlation between lactate levels in arterial and venous blood was found to be acceptable, and venous sampling should therefore be encouraged, as the risk and inconvenience for this procedure is minimal for the patient. The relevance of lactate guided therapy has to be supported by more studies.
登录
查看更多内容
影响因子：
120.7
作者：
Jones, Alan E.;Shapiro, Nathan I.;Trzeciak, Stephen;Arnold, Ryan C.;Claremont, Heather A.;Kline, Jeffrey A.
通讯作者：
Kline, Jeffrey A.
DOI：
10.1186/cc7159
发表时间：
2008
期刊：
Critical care (London, England)
影响因子：
--
作者：
Jansen TC;van Bommel J;Mulder PG;Rommes JH;Schieveld SJ;Bakker J
通讯作者：
Bakker J
影响因子：
3.1
作者：
Lee, S-W;Hong, Y-S;Baek, K-J
通讯作者：
Baek, K-J
影响因子：
38.9
作者：
Hatherill, M;McIntyre, AG;Murdoch, IA
通讯作者：
Murdoch, IA
影响因子：
6.2
作者：
Gallagher, EJ;Rodriguez, K;Touger, M
通讯作者：
Touger, M