[Blood group as a predictor of glycemia and lactatemia in critical condition patients.]

Hyperlactatemia is a dangerous metabolic shift, manifested in an increase in the blood lactate content above 2.2 mmol / l. Changes in the content of lactate affect the function of vital organs and systems, disrupting the course of biochemical processes. This condition accompanies a large number of clinical situations, also it is a major factor, worsening the clinical outcome and the patient's condition. The study of the characteristics of its occurrence and metabolic relationships helps to fulfill the diagnostic criteria for assessing the likelihood of an adverse outcome. The purpose of this study is to assess the variability of the content of lactate and glucose, as well as the glucose/lactate ratio, depending on the group of blood in the ABO system and the nosology of patients. 250 patients with various diseases whose condition required intensive care were examined, the middle age was 61.08 ± 13.6 years, and 446 practically healthy individuals who did not have acute somatic and infectious diseases, the middle age was 26.83 ± 1.46 years . We investigated the content of lactate and glucose, the glucose/lactate ratio, determined the belonging of the blood to ABO system. Statistical processing of the results was performed in the IBM SPSS Statistica 23.0. The data obtained indicate that patients with B (III) blood group have the highest lactate content in venous blood compared to the general population, and patients with AB (IV) blood group have the highest blood glucose level. In the group of patients with the highest median lactate content, the lowest glucose content was observed. The data presented demonstrate the importance of measuring and monitoring glucose, lactate, and their ratio in the management of patients in a life-threatening condition. Evaluation of metabolic variability depending on the different blood grouping of the ABO system in critical conditions involving hyperlactataemia can serve as an important tool in modeling a personalized approach to the patient.

[The indicators of basal metabolism in inflammatory syndrome bacterial origin: predictors of prognosis or the need for timely correction?]

The aim of the study was to determine the comparative significance of basal metabolism indicators and inflammatory process markers for the closest prognosis of patients in ICUs with systemic inflammation syndrome caused with infectious genesis. The paper presents the results of a retrospective analysis of the plan of treatment of 198 patients with confirmed clinical and laboratory signs of bacterial infection. The number of leukocytes, platelets, the percentage of lymphocytes, the concentration of procalcitonin, creatinine, bilirubin, C-reactive protein, acid-base balance values were determined in patients. Patients were assessed on a SOFA scale. The type of biomaterial for microbiological research was determined depending on the intended source of infectious inflammation. Identification of the isolated microorganisms was carried out using the MALDI ToF mass spectrometry method, followed by determination of antibiotic resistance. Empirical antibiotic therapy was prescribed upon admission of the patient to the ICU. Patients were switched to etiotropic antibacterial therapy after 48 hours, taking into account the results of a microbiological study. Determination of basal metabolic rate was carried out using the method of indirect calorimetry (CCM Express, Medical Graphics) with the calculation of basal metabolism, respiratory coefficient, absolute and relative amount of macronutrients. The calculation of the protein was made on the basis of the nitrogen level of the daily urine urea. Logistic analysis (ROC analysis) revealed that the antibacterial therapy strategy used, age, gender of patients, tinctorial properties of microorganisms isolated from patients, do not affect the nearest prognosis of the disease. On the contrary, SOFA score, the concentration of procalcitonin in the blood, and such parameters of the metabolic status as the need for kilocalories per kilogram of actual body weight and the percentage of protein calories significantly affect the nearest prognosis of the disease. The percentage of calories derived from protein metabolism, in the main exchange has a high reliable predictive value. The results of the study confirm the importance of adequate nutritional therapy in the treatment of patients with infectious inflammatory syndrome, including the calculation and correction of protein loss and total daily calorie.