Auswahl der wissenschaftlichen Literatur zum Thema „L-lactate levels“

Septic shock with AKI is associated with a high mortality. We evaluated whether continuous renal replacement therapy (CRRT) using a membrane (oXiris) with adsorbing properties could improve cardio-renal response and modulate endotoxin and cytokine levels. 105 patients requiring CRRT for septic shock-AKI received CRRT with an oXiris filter. The main cardio-renal parameters, SOFA total score, SOFA organ score, endotoxin and cytokine levels were measured at baseline (T0) and 72 h after the start of CRRT (T1). Norepinephrine infusion rate, blood lactate levels, and thromboelastographic parameters were monitored. At T1, the renal function improved (p < 0.01) urinary output increased ( p < 0,.01 ) with the cardiac response and the decrease of norepinephrine infusion. SOFA total decreased to 8.4 ± 3 from 12 ± 2 (p < 0.001). Endotoxin decreased also at T 1 ( p < 0.01) with a reduction of Il 6 and procalcitonin. Lactate level ranged from 3.37 ± 3.2mto 1.67 ± 1.8 mmol/l (p < 0.01). CRRT with the oxiris filter improves the cardio renal response response in septic patients with AKI. This is associated with a modulation of endo-toxemia, of cytokines and the stability of the coagulation parameters.

Sepsis is defined as life- threatening organ dysfunction caused by a detrimental host response to infection. Septic shock is a subset of sepsis in which underlying circulatory and cellular abnormalities are profound enough to substantially increase mortality. Septic shock is characterized by: ● The need for vasopressors to maintain mean arterial pressure (MAP) > 65mmHg despite adequate volume resuscitation. ● A serum lactate > 2mmol/L In lay terms, it is hypoperfusion with evidence of metabolic derangement. The mortality for both criteria is ~40%, compared to 20–30% for a single item. Please also refer to: https:// www.nice.org.uk/ guidance/indevelopment/gid-cgwave0686 The old definitions of sepsis described a heterogeneous group of patients and did not discriminate between infectious and non- infectious causes such as pancreatitis and trauma. The new definitions also allow easier recognition, based on a combination of symptoms and signs. Key parameters include: decreased level of consciousness, rigors, severe myalgia, high or low temperature, pulse > 130/min, systolic blood pressure < 90mmHg, respiratory rate (RR) > 25/ min, creatinine > 170μmol/ L, platelets < 100 x 109/l and bilirubin > 33μmol/ L. The Clinical Quality Commission recommend that NHS trusts use the national early warning score (NEWS), and a score > 5 is an indication to consider moving a patient to critical care. SIRS is defined as any of the two following criteria: acutely altered mental state, temperature < 36°C or > 38°C, pulse > 90/ min, RR > 20/ min, WCC > 12 or < 4 x 109/L and hyperglycaemia in the absence of diabetes mellitus. In the former definitions (1991 and 2001), sepsis was defined as infection plus SIRS. SIRS, however, was not good at separating infected patients who died from those who recovered from infection. SIRS was often an appropriate reaction to infection and many hospitalized patients meet the SIRS criteria. Also, as many as one in eight patients admitted to critical care units with infection and new organ failure did not have two SIRS criteria required to fulfil the sepsis definition. SIRS is no longer part of the new definitions.

Occupational compression sleeves are commonly used to relieve pain in the upper and lower extremities. Anecdotal data agree on the benefits of using compression sleeves while performing physical work. The purpose of this study was to assess the effects of wearing compression sleeves on the upper limbs on blood lactate concentration while completing a physically demanding activity. This study included six college-age participants from the University of Texas at El Paso. Anthropometric measurements were taken before the beginning of the study. Afterward, each participant’s basal capillary blood

Introdução: As cardiopatias são as maiores causas de morte materna indireta no ciclo gravídico- puerperal, com incidência de 4,2% das gestações em todo país. Entre as cardiomiopatias, a estenose da valva mitral (EM) destaca-se pela maior incidência e está relacionada com febre reumática nos países subdesenvolvidos. Relato de caso: Paciente do sexo feminino, 41 anos (G4 P0 A2 C2), branca, obesa, puérpera há três dias, procura atendimento em razão de desconforto respiratório. A paciente foi acompanhada no pré-natal de alto risco por conta de hipertensão arterial crônica e por possuir histórico d