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J Korean Soc Emerg Med > Volume 28(6); 2017 > Article
Journal of The Korean Society of Emergency Medicine 2017;28(6): 659-664.
당뇨병케톤산증 환자에서 내원 시 젖산과 응급실 처치에 따른 젖산 청소율의 효용성
주영욱1, 이동욱1, 김재우1, 박세훈1, 이정원1, 문형준1, 최재형1, 이현정1, 정윤현1, 김현수1, 전덕호2
1순천향대학교 천안병원 응급의학과
2순천향대학교 구미병원 응급의학과
Efficacy of Initial Lactate and Lactate Clearance by Emergency Department Treatment in Diabetic Ketoacidosis Patients
Young Wook Joo1, Dong Wook Lee1, Jae Woo Kim1, Sae Hoon Park1, Jae Hyung Choi1, Hyun Jung Lee1, Jung Won Lee1, Hyung Jun Moon1, Yoon Hyun Jung1, Hyun Su Kim1, Duck Ho Jun2
1Department of Emergency Medicine, Soonchunhyang University Cheonan Hospital, Soonchunhyang University College of Medicine, Cheonan1, Department of Emergency Medicine, Gumi, Korea
2Soonchunhyang University Gumi Hospital, Soonchunhyang University College of Medicine, Gumi, Korea
Correspondence  Dong Wook Lee ,Tel: 041-570-2119, Fax: 041-592-3806, Email: yisfm83@gmail.com,
Received: July 1, 2017; Revised: July 3, 2017   Accepted: September 29, 2017.  Published online: December 31, 2017.
ABSTRACT
Purpose:
Diabetic ketoacidosis (DKA) is a fatal complication caused by unregulated diabetes. Lactate is used as a prognostic indicator for a range of serious illnesses and its level is higher in DKA patients. This study examined the utility of lactate and lactate clearance measurements at an emergency department for predicting the prognosis of DKA patients.
Method:
This was a retrospective, observational study of patients with DKA presenting to the emergency department of an urban and rural tertiary hospital between January, 2013 and December, 2016. The demographic and laboratory data were collected through a chart review.
Results:
Seventy-six patients with DKA were included. Of these 76 patients, 46 (56.8%) had lactic acidosis (lactate >2.5 mmol/L) and 24 (29.6%) had a high lactate level (>4 mmol/L). Lactate and lactate clearance showed a significant difference in terms of the intensive care unit length of stay and mortality.
Conclusion:
Lactate and lactate clearance measurements in DKA patients are favorable and significant prognostic factors. In DKA patients, serial measurements of lactate should be considered.
Key words: Diabetic ketoacidosis, Lactic acid, Prognosis
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