Volume 6, Issue 3, September 2020, Page: 83-86
Serial Arterial Lactate Clearance and Outcome in Patients with Cardio-respiratory Insufficiency Presenting in Emergency Ward at Tertiary Level Hospital
Siddharth Dhoj Khati, Department of General Practice and Emergency Medicine, Karnali Academy of Health Sciences, Jumla, Nepal
Bishal Pokhrel, Department of Community Medicine and Public Health, Karnali Academy of Health Sciences, Jumla, Nepal
Rekha Karki, Medical Officer, Karnali Academy of Health Sciences, Jumla, Nepal
Received: Jun. 12, 2020;       Accepted: Jun. 28, 2020;       Published: Jul. 13, 2020
DOI: 10.11648/j.jfmhc.20200603.15      View  207      Downloads  39
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.
Keywords
Acute Cardio-respiratory Failure, ABG, AF, ATP, BPKIHS
To cite this article
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, Journal of Family Medicine and Health Care. Vol. 6, No. 3, 2020, pp. 83-86. doi: 10.11648/j.jfmhc.20200603.15
Copyright
Copyright © 2020 Authors retain the copyright of this article.
This article is an open access article distributed under the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0/) which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
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