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Laktacidoza pri kritično bolnih = Lactacidosis in critically-ill
Sinkovič, Andreja
Približno 50% bolnikov sprejetih v intenzivne enote ima povišanje laktata, ki pomeni povečano tveganje za bolnišnično umrljivost kritično bolnih. Samo povišanje laktata še ne pomeni laktacidoze. ...Laktacidoza je takrat, ko je ob povišanju koncentracije laktata v krvi (> 5 mmol/l) prisotna še acidoza s pH < 7,35. Laktacidoza je lahko posledica povečane tvorbe, ali zmanjšane razgradnje laktata ali obojega. Pri kritično bolnih je laktacidoza večinoma posledica šoka, pa tudi sepse, akutne okvare pljučne funkcije, astme, delovanja zdravil (kateholamini, metformin, propofol, nitroprusid), pomanjkanja tiamina, okvare jeter. Laktacidoza ne daje specifičnih simptomov in znakov. Simptomi in znaki ob laktacidozi so posledica bolezni, ki je vzrok za nastanek laktacidoze. Laktacidoza tako označuje težo patološkega stanja. Identifikacija vzroka za njen nastanek je nujna za vzpostavitev vzročnega zdravljenje laktacidoze. Kontrolne vrednosti laktata kažejo na učinkovitost zdravljenja in prognozo bolezni, ki je privedla do laktacidoze.
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