Correlations between serum lactate and intolerance of enteral nutrition in shock patients

YU Qing; MAO Zhi; CHEN Jinming; YANG Bin; HU Pan; XUE Chao; ZHOU Feihu

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Medical Journal of the Chinese People Armed Police Forces ›› 2020, Vol. 31 ›› Issue (4) : 291-295.

ORIGINAL ARTICLES

Correlations between serum lactate and intolerance of enteral nutrition in shock patients

YU Qing¹, MAO Zhi², CHEN Jinming¹, YANG Bin³, HU Pan², XUE Chao², ZHOU Feihu²

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Abstract

Objective To assess the correlations between serum lactate and intolerance of enteral nutrition(EN) in shock patients.Methods A retrospective study was conducted based on the review of medical records of ICU patients treated between January 1, 2015 and January 1, 2018. Shock patients who had received vasopressors and EN were included. Patients with a gastric residual volume ＞250 ml, vomiting, abnormalities in abdominal X ray or CT scan, intestinal ischemia or perforation were assigned to the intolerance group, and the rest to the tolerance group. The vasopressor dose, serum lactate level, EN amount and speed were recorded in both groups. The association of serum lactate with intolerance of enteral nutrition(EN) in shock patients was investigated.Results Among the 146 patients who had received EN and Ⅳ vasopressor therapy,114 were in the tolerance group, whereas 32 were in the intolerance group. The Acute Physiology and Chronic Health EvaluationⅡScores (APACHEⅡ), Sequential Organ Failure Assessment Scores(SOFA) and the maximum vasopressor dose of patients in the intolerance group were not significantly different from those of the tolerance group(P＞0.05). However, both the serum lactate level(P<0.001) and Acute Gastrointestinal Injury grade (AGI grade) (P＜0.001)of patients in the intolerance group were significantly higher than those in the tolerance group. Multiple regression analysis showed that an increased serum lactate level(＞2.0 mmol/L) was an independent predictor of EN intolerance[OR,6.8;95%CI(2.9-16.0)].Conclusions In patients with shock, the increased lactate level may predict the risk of EN intolerance.

Key words

enteral nutrition / acute gastrointestinal injury / tolerance / shock

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YU Qing, MAO Zhi, CHEN Jinming, YANG Bin, HU Pan, XUE Chao, ZHOU Feihu. Correlations between serum lactate and intolerance of enteral nutrition in shock patients[J]. Medical Journal of the Chinese People Armed Police Forces. 2020, 31(4): 291-295

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