Efficacy of Initial Lactate and Lactate Clearance by Emergency Department Treatment in Diabetic Ketoacidosis Patients

Joo, Young Wook; Lee, Dong Wook; Kim, Jae Woo; Park, Sae Hoon; Choi, Jae Hyung; Lee, Hyun Jung; Lee, Jung Won; Moon, Hyung Jun; Jung, Yoon Hyun; Kim, Hyun Su; Jun, Duck Ho

J Korean Soc Emerg Med > Volume 28(6); 2017 > Article

Original 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