GIÁ TRỊ TIÊN LƯỢNG TỬ VONG CỦA ĐỘ THANH THẢI LACTATE MÁU TRÊN BỆNH NHÂN NHIỄM TRÙNG HUYẾT VÀ SỐC NHIỄM KHUẨN TẠI KHOA HỒI SỨC TÍCH CỰC BỆNH VIỆN ĐA KHOA TRUNG TÂM AN GIANG

Abstract

Background: Severe sepsis and septic shock have high mortality rate globally as well as in Vietnam despite of treatment recommendations. Lactate clearance helps to monitor the recovery of tissue perfusion and progressive condition, so that improves the outcome. Objectives: 1). To assess the lactate values in patients with severe sepsis at times of 0 hours, 6 hours, 12 hours; 2). To survey the relationship between lactate clearance at times of 6 hours, 12 hours and lethal risk of patient with severe sepsis. Materials and methods: A cross-sectional descriptive study was conducted on 100 patients who were diagnosed with severe sepsis or septic shock treated at An Giang Central Hospital from February 2020 to August 2020. Result: Most of the sites of infection were intestinal tract (32%) and pneumonia (31%). All cases were admitted with very severe condition, SOFA scores were high (SOFA>8 in 59%). Mean lactate at the time of admission was high 7.33 mmol/L.  Lactate clearance at 6 hours and 12 hours after resuscitaion in survivals (31.68 ± 27.31 and 57.35 ± 21.81) was better than in nonsurvivals (-50.91 ± 40.31 và -126.18 ± 62.68). The patients with lactate clearence more than 10% at 6 hours and 12 hours had lower mortality (3.33% and 1.49% death, respectively) than the patients with lactate clearence less than 10% (75% and 96.97% death, respectively). Conclusion: Lactate clearance in the first 6 hours was an independent prognostic factor in patients with severe sepsis or septic shock. Probability of nosurvival of low lactate clearance group was always higher than high lactate clearance group. Monitoring of lactate clearance was useful for outcome.