乳酸指导性治疗改善心脏术后患者的预后

目的对于心脏术后的患者给予连续监测血乳酸,并根据血乳酸水平调整治疗方案,以确定这种方法是否能改善患者的预后。方法对于连续收治的82名心脏术后患者分成两组,这两组除了一组测定乳酸水平其他治疗相同。观察死亡率、肺内感染的发生率、上呼吸机时间、住院时间等指标。以评估乳酸指导性治疗是否能改善心脏术后患者的预后。结果乳酸指导性治疗可以明显改善心脏患者的死亡率,住院时间。结论使用血乳酸水平可以更好地监测患者组织水平的灌注是否充分,结合使用中心静脉压对于补液及心功能的调整比单独使用中心静脉压更有优势,能很好地改善患者的预后。

Lactate-directed medical therapy improves outcomes after heart surgery

Objective] To reduce the mortality of patients after heart surgery with a goal-directed therapy algorithm. Methods] Prospective study of patients undergoing surgery utilizing a goal-directed therapy algorithm in the postoperative period. The results of this group were compared with a historical cohort. Patients undergoing surgery from July 2003 through October 2005 were compared with cohorts from June 2001 through June 2003 in a 15-bed general intensive care unit of a general hospital. Beginning in July 2003, blood lactate measurements were performed serially for 24 h after heart surgery. Based on lactate values and trends, therapy was amended. Results] Mortality was lower for group A. The recovery time duration of normal blood pressure and urine volume was sooner in Group A than that in Group B. Conclusions] The lactate-directed medical therapy associated with a marked decrease in mortality for patients undergoing heart surgery makes the time duration of recovery sooner in lactate-directed group.