ABSTRACT
Se ha descrito un incremento del lactato sanguíneo en algunos pacientes tratados por agudización del asma. Sin embargo, se desconoce su frecuencia y el significado clínico en la práctica clínica habitual. El objetivo del estudio ha sido evaluar las características asociadas a la presencia de hiperlactatemia en la gasometría arterial de pacientes que requirieron ingreso en la sala de neumonología por agudización del asma. Se realizó un estudio retrospectivo de las altas hospitalarias de un servicio de neumonología durante 3 años (2015 a 2017) analizando los valores del ácido láctico en la gasometría arterial y su posible relación con datos de antecedentes clínicos, de laboratorio, tratamiento, espirometría, estancia hospitalaria o uso de unidades de cuidados críticos. Se incluyeron 112 pacientes con 182 ingresos. Presentaron en alguna ocasión hiperlactatemia (> 2.2 mmol/l) 32 pacientes (29%). En 42 de los 182 ingresos (23%) se observó aumento de lactato, en quienes tenían mayor estancia hospitalaria (mediana 6 vs. 5 días, p = 0.013). En 8 de los 10 ingresos en unidades de cuidados críticos se observó hiperlactatemia, en general tras recibir el tratamiento broncodilatador. En las gasometrías con hiperlactatemia existía una correlación significativa entre lactato y bicarbonato (r = -0.417, p=0.003) y el exceso de base (r = -0.484, p < 0.001). La hiperlactatemia es relativamente frecuente en las gasometrías realizadas a los pacientes hospitalizados por asma (23% de los ingresos). Los ingresos con hiperlactatemia se asociaron a una internación más prolongada.
Increased levels of lactic acid have been described in patients treated for asthma exacerbation. However, the frequency and clinical significance of hyperlactatemia in real-world practice is unknown. The objective of the study was to evaluate the characteristics associated with hyperlactatemia in blood gas analysis of patients with asthma exacerbation hospitalized in a pulmonary department. This is a retrospective 3-year study (2015 to 2017) of patients discharged from the pulmonary department. The level of lactic acid in the blood gas test and the possible relationship with clinical, laboratory, therapy, spirometric values, hospitalization length and use of critical care resources were analyzed. A total of 112 patients with 182 admissions were included in the study. Thirty-two (29%) patients had hyperlactatemia in at least one blood gas analysis. Elevated lactic acid was observed in 42 of 182 admissions (23%), which had larger length hospital stay (median, 6 vs. 5 days, p = 0.013). Hyperlactatemia was present in 8 of 10 admissions in the critical care units, mainly after receiving bronchodilator therapy. There was a significant correlation between lactate level and bicarbonate level (r = -0.417, p = 0.003) and between lactate level and base excess (r = -0.484, p < 0.001) in cases with hiperlactatemia. Hyperlactatemia is a relatively frequent finding in blood gas analysis of patients hospitalized because of asthma (23% of admissions). These admissions with hiperlactatemia are associated with larger hospital length of stay.
Subject(s)
Humans , Male , Female , Adult , Middle Aged , Aged , Asthma/blood , Asthma/epidemiology , Hyperlactatemia/epidemiology , Spain/epidemiology , Spirometry , Blood Gas Analysis/methods , Acute Disease , Retrospective Studies , Risk Factors , Statistics, Nonparametric , Length of StayABSTRACT
The objective of this investigate was effect of different levels of triticale on potato plant waste silage degradability byGas production. This technique by mixtures of filtered rumen liquid of five Holstein male cattle in times of 0, 2, 4, 6, 8, 12, 24, 48, 72 and 96 hours were performed. The resultreported that gas volume at 16h and 24h incubation of control treatment, were33.7 ml/200mg DM and 39.05 ml/200mg DM respectively. The gas test, from soluble fraction (ac%), and from insoluble fraction (bc%), rate constant of gas production during incubation (cc%) and the potential gas production (a+ bc%) contents of control treatment were 11.1, 47.7, 0.02 (ml/h) and 58.1 ml/200mg DM, but for treatment 6% were 21.9, 55.25, 0.04 (ml/h) and 77.15 ml/200 mg DM. According to data, potato plant waste silage could use as an excellent source of dietary nutrient in ruminant animals.