Objective: To investigate the prognosis value of lactate and lactate clearance rate in patients during burn shock stage. Methods: 88 patients with blood lactate>2.0 mmol/L during burn shock in the hosptital burn unit were retrospectively analyzed. The patients were divided into survivor group (n=48) and death group (n=40) according to whether they survived on 28th day. Blood lactate levels were measured at admission (0 h) and at 6 h, 12 h, 24 h and 72h after admission. The partial pressure of blood oxygen was recorded, as well as the acute physiology and chronic health evaluation (APACHE Ⅱ). The correlation of the lactate blood level at 0 h, PO2 between APACHE Ⅱ scores, and the relationship between lactate clearance and prognosis was analyzed at each time point. Results: Blood lactate levels at 0 h, 6 h, 12 h, 24 h and 72 h in the death group were significantly higher than those in the surviving group, resoectively. Lactate levels of patients during burn shock on admission were significantly associated with APACHE II scores (P<0.01), but not with partial pressure of oxygen (P>0.05). Multivariate logistic regression analysis showed that the lactate clearance rate at 6 h and 12 h could be used as a prognostic factor to independently evaluate the prognosis. Conclusions: The dynamic monitoring of blood lactate is of great significance in patients with burn shock. Persistent hyperlactacidemia indicates a poor prognosis. The lactic acid clearance rate at 6 h and 12 h may be used as indices for prognostic evaluation. |
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