Objective:To explore the value of arterial blood lactate and early lactate clearance in evaluating the prognosis in patients with COPD merged with respiratory failure.Methods:A total of 78 patients with COPD merged wi...Objective:To explore the value of arterial blood lactate and early lactate clearance in evaluating the prognosis in patients with COPD merged with respiratory failure.Methods:A total of 78 patients with COPD merged with respiratory failure were included in the study. The arterial blood lactate level 1 d before treatment and 6 h after treatment was detected. The early lactate clearance was evaluated. The patients were divided into the severe elevation group, mild elevation group, and normal control group according to the blood lactate level. APACHEⅡ score, 28 d death rate, and other clinical related indicators in the three groups were compared. According to the early lactate clearance, the patients were divided into the high lactate clearance group and low lactate clearance group. The arterial blood lactate level, APACHEⅡ score, death rate, and arterial blood gas indicators in the two groups were compared. The multiple-factor analysis of prognosis was performed.Results:With the increasing of blood lactate concentration before treatment, APACHEⅡ score, mechanical ventilation time, ventilation rate, hospitalization time, and death rate were gradually elevated, and the comparison among the three groups was not statistically significant. When compared with before treatment, the arterial blood lactate level, APACHEⅡ score, and PaCO2 in the high lactate clearance group were significantly reduced, but PaO2 and pH were significantly elevated, while PaO2 in the low lactate clearance group was significantly elevated. The death rate in the high lactate clearance group was significantly lower than that in the low lactate clearance group. The early lactate clearance was a factor in protecting the prognosis in patients with COPD merged with respiratory failure.Conclusions:The arterial blood lactate level and early lactate clearance can affect the prognosis in patients with COPD merged with respiratory failure. Dynamic monitoring of early blood lactate level can better evaluate the disease severity degree and prognosis.展开更多
文摘Objective:To explore the value of arterial blood lactate and early lactate clearance in evaluating the prognosis in patients with COPD merged with respiratory failure.Methods:A total of 78 patients with COPD merged with respiratory failure were included in the study. The arterial blood lactate level 1 d before treatment and 6 h after treatment was detected. The early lactate clearance was evaluated. The patients were divided into the severe elevation group, mild elevation group, and normal control group according to the blood lactate level. APACHEⅡ score, 28 d death rate, and other clinical related indicators in the three groups were compared. According to the early lactate clearance, the patients were divided into the high lactate clearance group and low lactate clearance group. The arterial blood lactate level, APACHEⅡ score, death rate, and arterial blood gas indicators in the two groups were compared. The multiple-factor analysis of prognosis was performed.Results:With the increasing of blood lactate concentration before treatment, APACHEⅡ score, mechanical ventilation time, ventilation rate, hospitalization time, and death rate were gradually elevated, and the comparison among the three groups was not statistically significant. When compared with before treatment, the arterial blood lactate level, APACHEⅡ score, and PaCO2 in the high lactate clearance group were significantly reduced, but PaO2 and pH were significantly elevated, while PaO2 in the low lactate clearance group was significantly elevated. The death rate in the high lactate clearance group was significantly lower than that in the low lactate clearance group. The early lactate clearance was a factor in protecting the prognosis in patients with COPD merged with respiratory failure.Conclusions:The arterial blood lactate level and early lactate clearance can affect the prognosis in patients with COPD merged with respiratory failure. Dynamic monitoring of early blood lactate level can better evaluate the disease severity degree and prognosis.
