tailieunhanh - Báo cáo khoa học: "The origin and interpretation of hyperlactataemia during low oxygen delivery states"

Tuyển tập các báo cáo nghiên cứu về y học được đăng trên tạp chí y học Critical Care giúp cho các bạn có thêm kiến thức về ngành y học đề tài: The origin and interpretation of hyperlactataemia during low oxygen delivery states. | Available online http content 11 1 104 Commentary The origin and interpretation of hyperlactataemia during low oxygen delivery states Jonathan Handy Chelsea Westminster Hospital Imperial College London 369 Fulham Road London SW10 9NH UK Corresponding author Jonathan Handy Published 12 January 2007 This article is online at http content 11 1 104 2007 BioMed Central Ltd Critical Care 2007 11 104 doi cc5137 See related research by Ranucci et al. http content 10 6 R167 Abstract The origin of hyperlactataemia during critical illness is complex but its presence can provide an indicator of inadequate tissue oxygen delivery. Cardiopulmonary bypass CPB represents a unique situation where systemic oxygen delivery can be directly measured and controlled. In the previous issue of Critical Care Ranucci and colleagues use this phenomenon to identify independent variables associated with the development of hyperlactataemia during CPB. In doing so they highlight the complexity of interpreting hyperlactataemia during critical illness and provide further evidence of its association with worse postoperative morbidity. Introduction The association of hyperlactataemia and acidosis with worsened clinical outcome has been demonstrated in numerous patient and disease states 1 2 . However hyper-lactataemia itself has complex origins and is variably associated with acidosis and with patient morbidity and mortality. The latter depends greatly on the origin of lactate production. Type A hyperlactataemia is associated with anaerobic respiration inadequate tissue oxygen delivery acidosis and increased morbidity and mortality 3 . Type B hyper-lactataemia occurs in the presence of adequate oxygen delivery with increased substrate utilisation. Differentiation between these aetiologies is important because they represent discrete metabolic processes with differing therapies and prognoses. Hyperlactataemia developing during .

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