Dynamic Observation of Blood Lactate Level and Prognosis Judgment of Shock Patients in Intensive Care Unit

Objective To evaluate the value of dynamic blood lactate level and lactate clearance rate in the prognosis judgment of patients with shock in intensive care unit(ICU).Methods Fifty-eight adult shock patients from Sep.2008 to Jun.2010 were included in this study.All eligible patients received the etilogical treatment,symptomatic treatment and supporting therapy.The level of the lactate at 0 h,6 h,24 h,48 h(then each 24 h) were detected after admission in ICU,and the lactate clearance rate at 24 h and 48 h were calculated.The relation between lactate level,lactate clearance rate and the prognosis judgment of patients were evaluated.Results In all 42 shock patients,there were 25 septic shock and 17 hypovolemic shock;there were 25 male and 17 female cases,their mean age was(53.92±17.59) years.The average APACHE Ⅱ score at 0 h was 20±4,and the average concentration of lactate in blood was(9.04±2.55) mmol/L.The concentration of lactate at 0 h,6 h and 24 h in survival group were significantly lower than the death group,while the lactate clearance rate at 6 h and 24 h in the survival group were significantly higher than that in the death group.There was no significant difference in the duration of high lacticemia between two groups.Conclusion Dynamic observation of lactate level is very important for the shock patients.The 6 h and 24 h lactate clearance rate may be an important indicator in predicting the prognosis of patients with shock.