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Bratislava Medical Journal Vol.114, No.11, p.637-641, 2013 |
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Title: Normalization of blood lactate as early end-point of polytrauma treatment | ||
Author: K. Galkova, M. Vrabelova | ||
Abstract: Background: The main aim of the early treatment of polytrauma is recovery of patient’s physiological functions. The early achievement of therapeutic goals, mainly adequate tissue perfusion and repayment of oxygen debt, are postulated. Methods: Sixty-nine mechanically ventilated patients with a severe trauma and organ dysfunction defined according to SOFA score and ISS >17, age >15 years, were enrolled into this retrospective study. 8 patients died within first 24 hours, 8 patients did not reach serum lactate level above 2 mmol/l on admission to hospital. The hypothesis that normalization of serum lactate level within 24 hours is related to lower mortality and morbidity, was assessed. Reduced mortality and morbidity were represented by lower severity of multi-organ dysfunction, the highest SOFA score during hospitalization, lower incidence of sepsis, number of days in ICU and artificial ventilation. Results: The association between severity of multi-organ failure (p=0.0006), mortality (p=0.0022) and repayment of oxygen debt was confirmed. Hypothesis of sepsis incidence was not confirmed (p=0.34). The association between number of days on artificial ventilation and number of days in ICU to repayment of oxygen debt was not confirmed either. Multivariate significant factors were age, GCS, ISS and SOFA score on patient’s admission. |
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Keywords: polytrauma, lactate, MOF, SOFA score. | ||
Year: 2013, Volume: 114, Issue: 11 | Page From: 637, Page To: 641 | |
doi:10.4149/BLL_2013_136 |
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