The role of D-lactate gradient across the lung in the diagnosis and therapeutic evaluation of pneumonia / 重庆医学

ABSTRACT

Objective To study the role of D‐lactate gradient across the lung in the rapid diagnosis of pneumonia and evalua‐tion of therapeutic efficacy .Methods Patients were divided into pneumonia group (n=46) and non‐pneumonia group (n=28) in ICU .D‐lactate gradient across the lung were calculated by the difference between arterial and mixed‐venous D‐lactate concentrations before the treatment ,after 3 and 7 days of treatment .Serum procalcitonin (PCT) ,Oxygenation index ,the lung injury score (LIS) and clinical pulmonary infection score(CPIS) were recorded at the same time .Results The mean D‐lactate gradient across the lung in pneumonia group was significantly higher than that in non‐pneumonia group[(163 .84 ± 10 .72) ng/mL vs .(30 .33 ± 7 .25) ng/mL ,P<0 .01) ]before treatment .Using a cut‐off value of 106 .11 ng/mL ,D‐lactate gradient across the lung′s sensitivity for di‐agnosis pneumonia was 90 .7% and its′specificity was 75 .5% .D‐lactate gradient across the lung correlated with LIS (r= 0 .554 , P<0 .01) and CPIS(r=0 .543 ,P<0 .01) .Conclusion D‐lactate gradient across the lung correlates with lung injury and pulmonary infection positively and may be a potential biomarker for rapid diagnosis of pneumonia .