Lactate levels with regards to the pulse pressure in patients with shock
Main Article Content
Keywords
Shock, Lactic acid, Blood pressure
Abstract
Background: Lactate is one of the most useful biomarkers to screen patients with shock; therefore, the aim of this study was to establish the levels of lactate regarding the pulse pressure in that sort of patients.
Methods: Observational, retrospective, cross-sectional and descriptive study of patients over 18 years diagnosed with shock from an emergency room of a tertiary care hospital. Lactate levels and pulse pressure were used as biomarkers. We used descriptive statistics, Student’s t test and Pearson correlation coefficient.
Results: We obtained 46 patients. The average age was 39.52 (SD 15.22), media initial lactate level was 5.88 mmol/L (SD 3.89) and media final lactate level 3.31 mmol/L (SD = 3.12); initial pulse pressure was 19.78 mmHg (SD 7.45) and final pulse pressure 31.52 mmHg (SD 31.52). The relation of secundary diagnosis did show predominance in chest trauma with 13 patients. There was a statistical significance in initial lactate and final lactate of r = 0.83 (p = 0.00), and initial pulse pressure and final pulse pressure: r = 0.57 (p = 0.001). There was not a significant correlation between final lactate and final pulse pressure (r = 0.184, p = 0.222).
Conclusions: Even when several studies emphasize the clinical significance of biomarkers in the diagnosis and management of patients with hypovolemic shock, it is necessary to do more studies in order to find the efficacy of the non-invasive screening in this type of pathology.
References
Manji RA, Wood KE, Kumar A. The history and evolution of circulatory shock. Crit Care Clin. 2009;25(1):1-29.
Jones AE. Lactate clearance vs central venous oxygen saturation as goals of early sepsis therapy: a randomized clinical trial. JAMA. 2010;303(8):739-46.
Tisherman SA, Barie P, Bokhari F, Bonadies J, Daley B, Diebel L, et al. Clinical practice guideline: endpoints of resuscitation. J Trauma. 2004;57(4):898-912.
Pocock SJ, McCormarck V, Gueyffier F, Boutitie F, Fagard RH, Boissel JP. A score for predicting risk of death from cardiovascular disease adults with raised blood pressure, based on individual patient from randomised controlled trials. BMJ. 2001;323(7304):75-81.
John AM, Robert S, Kockberger R. Rosen medicina de urgencias, conceptos y práctica clínica. 5ª ed. Estados Unidos: Elsevier Science; 2005.
Winters MA, McCurdy MT, Zilberstein J. Monitoring the critically ill emergency department patient. Emerg Med Clin N Am. 2008; 26(3):741-57.
Cruces P, Salomón T, Carvajal C, Erranz B. Variación de presión de pulso en ventilación mecánica. Rev Chil Med Inten. 2007;22(2):114-7.
Michard F. Changes in arterial pressure during mechanical ventilation. Anesthesiology. 2005;103(2):419-28.
Marik PE, Baram M. Noninvasive hemodynamic monitoring in the intensive care unit. Crit Care Clin. 2007;23(3):383-400.