Introduction: Acute cardio-respiratory failure is one of the acute common problems encountered in emergency and which required immediately intervention. It creates an imbalance between energy supply, demand, and consumption. Earlier lactate clearance should be useful to identify patient able to reverse the metabolic derangement and failure to rapidly resolve the oxygen debt, indicated by poor lactate clearance, would be correlated with negative outcome. For this purpose lactate clearance at 2 hour is more useful. Methods: This was a prospective study conducted at B. P. Koirala Institute of Health Sciences, Dharan, Nepal. Preliminary diagnosis was made according to clinical history, physical examination, arterial blood gas and chest radio graph. A national emergency warning system was used for patient evaluation. Gas exchange and lactate blood concentration was assessed at Emergency ward at arrival, 2 & 6 hr. Two-hour lactate clearance was calculated as (Lactate start − lactate 2 hour)/lactate start (%). Blood gas-analysis and arterial lactate was performed by intermittent blood sampling and co-oximetry. Results: Out of 74 patients the COPD was the most common co-morbidity condition (25.7%), followed by congestive heart failure (18.9%). Comprising of lactate clearance at two hours and the lactate clearance at six hours, the lactate clearance at two hours and its outcomes was more significant (P=0.001, OR=10.133) than lactate clearance at six hours (P=0.213). Conclusions: Early lactate clearance was associated with positive outcome rather than late clearance.
| Published in | Journal of Family Medicine and Health Care (Volume 6, Issue 3) |
| DOI | 10.11648/j.jfmhc.20200603.15 |
| Page(s) | 83-86 |
| Creative Commons |
This is an Open Access article, distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution and reproduction in any medium or format, provided the original work is properly cited. |
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Copyright © The Author(s), 2024. Published by Science Publishing Group |
Acute Cardio-respiratory Failure, ABG, AF, ATP, BPKIHS
| [1] | Defrances CJ, Ph D, Lucas CA, Buie VC, Golosinskiy A. 2006 National Hospital Discharge Survey. 2008. |
| [2] | Dubey L, Sharma SK, Chaurasia AK. Clinical profile of patients hospitalized with heart failure in Bharatpur, Nepal. J Cardiovasc Thorac Res. 2012; 4 (4): 103–5. |
| [3] | Jacobsen G, Muzzin A, Ressler JA, Tomlanovich MC. Early lactate clearance is associated with improved outcome in severe sepsis and septic shock*. Crit Care Med. 2004; 32 (8). |
| [4] | Kruse O, Grunnet N, Barfod C. Blood lactate as a predictor for in-hospital mortality in patients admitted acutely to hospital: a systematic review. Scand J Trauma Resusc Emerg Med [Internet]. 2011; 19 (1): 74. Available from: http://www.sjtrem.com/content/19/1/74. |
| [5] | Nguyen HB, Loomba M, Yang JJ, Jacobsen G, Shah K, Otero RM, et al. Early lactate clearance is associated with biomarkers of inflammation, coagulation, apoptosis, organ dysfunction and mortality in severe sepsis and septic shock. J Inflamm. 2010; 7 (6): 1–11. |
| [6] | Pnadey R, Chokhani R, N B KC. Use of non invasive ventilation in patients with respiratory failure in Nepal. [Internet]. 2011. p. 256–9. Available from: http://ovidsp.ovid.com/ovidweb.cgi?T=JS&PAGE=reference&D=medl&NEWS=N&AN=22710534. |
| [7] | Scott S, Antonaglia V, Guiotto G, Paladino F, Schiraldi F. Two-hour lactate clearance predicts negative outcome in patients with cardiorespiratory insufficiency. Crit Care Res Pract. 2010; 917053: 6. |
| [8] | Vincent J-L, Akça S, De Mendonça A, Haji-Michael P, Sprung C, Moreno R, et al. The epidemiology of acute respiratory failure in critically ill patients (*). Clin Investig Crit care. 2002; 121 (1609): 1602–9. |
| [9] | National Early Warning Score National Early Warning Score (NEWS) 2. 2017. |
| [10] | Bakker J, Jansen TC. Don ’ t take vitals, take a lactate. Intensive Care Med. 2007; 33: 1863–5. |
APA Style
Siddharth Dhoj Khati, Bishal Pokhrel, Rekha Karki. (2020). Serial Arterial Lactate Clearance and Outcome in Patients with Cardio-respiratory Insufficiency Presenting in Emergency Ward at Tertiary Level Hospital. Journal of Family Medicine and Health Care, 6(3), 83-86. https://doi.org/10.11648/j.jfmhc.20200603.15
ACS Style
Siddharth Dhoj Khati; Bishal Pokhrel; Rekha Karki. Serial Arterial Lactate Clearance and Outcome in Patients with Cardio-respiratory Insufficiency Presenting in Emergency Ward at Tertiary Level Hospital. J. Fam. Med. Health Care 2020, 6(3), 83-86. doi: 10.11648/j.jfmhc.20200603.15
AMA Style
Siddharth Dhoj Khati, Bishal Pokhrel, Rekha Karki. Serial Arterial Lactate Clearance and Outcome in Patients with Cardio-respiratory Insufficiency Presenting in Emergency Ward at Tertiary Level Hospital. J Fam Med Health Care. 2020;6(3):83-86. doi: 10.11648/j.jfmhc.20200603.15
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Download@article{10.11648/j.jfmhc.20200603.15,
author = {Siddharth Dhoj Khati and Bishal Pokhrel and Rekha Karki},
title = {Serial Arterial Lactate Clearance and Outcome in Patients with Cardio-respiratory Insufficiency Presenting in Emergency Ward at Tertiary Level Hospital},
journal = {Journal of Family Medicine and Health Care},
volume = {6},
number = {3},
pages = {83-86},
doi = {10.11648/j.jfmhc.20200603.15},
url = {https://doi.org/10.11648/j.jfmhc.20200603.15},
eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.jfmhc.20200603.15},
abstract = {Introduction: Acute cardio-respiratory failure is one of the acute common problems encountered in emergency and which required immediately intervention. It creates an imbalance between energy supply, demand, and consumption. Earlier lactate clearance should be useful to identify patient able to reverse the metabolic derangement and failure to rapidly resolve the oxygen debt, indicated by poor lactate clearance, would be correlated with negative outcome. For this purpose lactate clearance at 2 hour is more useful. Methods: This was a prospective study conducted at B. P. Koirala Institute of Health Sciences, Dharan, Nepal. Preliminary diagnosis was made according to clinical history, physical examination, arterial blood gas and chest radio graph. A national emergency warning system was used for patient evaluation. Gas exchange and lactate blood concentration was assessed at Emergency ward at arrival, 2 & 6 hr. Two-hour lactate clearance was calculated as (Lactate start − lactate 2 hour)/lactate start (%). Blood gas-analysis and arterial lactate was performed by intermittent blood sampling and co-oximetry. Results: Out of 74 patients the COPD was the most common co-morbidity condition (25.7%), followed by congestive heart failure (18.9%). Comprising of lactate clearance at two hours and the lactate clearance at six hours, the lactate clearance at two hours and its outcomes was more significant (P=0.001, OR=10.133) than lactate clearance at six hours (P=0.213). Conclusions: Early lactate clearance was associated with positive outcome rather than late clearance.},
year = {2020}
}
TY - JOUR T1 - Serial Arterial Lactate Clearance and Outcome in Patients with Cardio-respiratory Insufficiency Presenting in Emergency Ward at Tertiary Level Hospital AU - Siddharth Dhoj Khati AU - Bishal Pokhrel AU - Rekha Karki Y1 - 2020/07/13 PY - 2020 N1 - https://doi.org/10.11648/j.jfmhc.20200603.15 DO - 10.11648/j.jfmhc.20200603.15 T2 - Journal of Family Medicine and Health Care JF - Journal of Family Medicine and Health Care JO - Journal of Family Medicine and Health Care SP - 83 EP - 86 PB - Science Publishing Group SN - 2469-8342 UR - https://doi.org/10.11648/j.jfmhc.20200603.15 AB - Introduction: Acute cardio-respiratory failure is one of the acute common problems encountered in emergency and which required immediately intervention. It creates an imbalance between energy supply, demand, and consumption. Earlier lactate clearance should be useful to identify patient able to reverse the metabolic derangement and failure to rapidly resolve the oxygen debt, indicated by poor lactate clearance, would be correlated with negative outcome. For this purpose lactate clearance at 2 hour is more useful. Methods: This was a prospective study conducted at B. P. Koirala Institute of Health Sciences, Dharan, Nepal. Preliminary diagnosis was made according to clinical history, physical examination, arterial blood gas and chest radio graph. A national emergency warning system was used for patient evaluation. Gas exchange and lactate blood concentration was assessed at Emergency ward at arrival, 2 & 6 hr. Two-hour lactate clearance was calculated as (Lactate start − lactate 2 hour)/lactate start (%). Blood gas-analysis and arterial lactate was performed by intermittent blood sampling and co-oximetry. Results: Out of 74 patients the COPD was the most common co-morbidity condition (25.7%), followed by congestive heart failure (18.9%). Comprising of lactate clearance at two hours and the lactate clearance at six hours, the lactate clearance at two hours and its outcomes was more significant (P=0.001, OR=10.133) than lactate clearance at six hours (P=0.213). Conclusions: Early lactate clearance was associated with positive outcome rather than late clearance. VL - 6 IS - 3 ER -
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