VAI TRÒ CỦA ĐỘ THANH THẢI LACTATE TRONG TIÊN LƯỢNG TỬ VONG Ở BỆNH NHÂN SỐC NHIỄM KHUẨN

Abstract

Background: Septic shock is a common disease in the intensive care units with a high mortality rate of about 40-60%. The treatment of this is a great challenge which requires many different methods. Serum lactate is an indrirect parameter reflecting the perfusion status of organs commonly used in sepsis and septic shock. Lactate clearance plays as a mean to monitor tissue perfusion recovery and the outcome of shock resuscitation, thereby improving treatment efficacy. Objectives: To determine the mortality prognostic value of lactate serum clearance in patients with septic shock. Materials and methods: A prospective study on 130 septic shock patients in Kien Giang General Hospital. Results: The mortality rate was 60.8%. Serum lactate median was 5.48mmol/L. There was a significant difference in lactate clearance between the living and the dead, that the living group had higher lactate clearance compared with the death one. Lactate clearance at 6h and 12h post-hospitalization were 0.809 and 0.847 respectively, with p<0.001. The optimal cut-off point of lactate clearance after 6 hours of admission was -1.76% (with sensitivity of 82.3% and specificity of 78.4%) and at 12 hours of admission was -10.56% (with sensitivity of 86.1% and specificity of 86.3%). Conclusions: Lactate clearance at 6 hours and 12 hours after admission is a worthy measure in predicting mortality in patients with septic shock.