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Title:Dinamika vrednosti kapilarnega laktata pri srčnem zastoju v izvenbolnišničnem okolju
Authors:ID Vujanović, Vitka (Author)
ID Strnad, Matej (Mentor) More about this mentor... New window
ID Mekiš, Dušan (Comentor)
Files:.pdf DOK_Vujanovic_Vitka_2025.pdf (2,28 MB)
MD5: EEC19E080FD61B5384D25FECBB4BFE10
 
Language:Slovenian
Work type:Dissertation
Typology:2.08 - Doctoral Dissertation
Organization:MF - Faculty of Medicine
Abstract:Izhodišča: Temelj učinkovitega kardiopulmonalnega oživljanja je vzpostavitev čim boljše tkivne perfuzije. Namen študije je bil ugotoviti povezavo med kapilarnimi vrednosti laktata, začetnim ritmom in verjetnostjo ponovne vzpostavitve spontanega krvnega obtoka pri bolnikih z zunajbolnišničnim srčnim zastojem. Metode: V raziskavo smo vključili vse bolnike z netravmatskim srčnim zastojem izven bolnišnice, starejše od 18 let, ki jih je oživljala predbolnišnična ekipa nujne medicinske pomoči med aprilom 2020 in junijem 2021. Vzorci kapilarnega laktata so bili zbrani ob prihodu in v 10 minutih intervalih po prvi meritvi do trenutka vrnitve spontanega krvnega obtoka (ROSC) ali, v kolikor ROSC ni bil dosežen, v času razglasitve smrti na kraju dogodka. Rezultati: V študijo je bilo vključeno 83 bolnikov. ROSC je bil dosežen pri 28 bolnikih (33,7 %), 21 jih je bilo sprejetih v bolnišnico (26,3 %), 6 (7,23 %) pa jih je bilo odpuščenih iz bolnišnice. Inicialne vrednosti kapilarnega laktata so bile značilno višje pri bolnikih z nešokabilnim ritmom v primerjavi s skupino s šokabilnim ritmom (9,19 ± 4,6 proti 6,43 ± 3,81; p = 0,037). Pomembna razlika med skupinama je obstajala tudi pri drugem vzorcu, vzetem 10 minut po začetni vrednosti, (10,03 ± 5,19 proti 5,18 ± 3,47; p = 0,019). Povprečne vrednosti kapilarnega laktata so bile višje v skupini z ROSC v primerjavi s skupino brez ROSC (11,10 ± 6,59 oziroma 6,77 ± 4,23; p = 0,047) in so sovpadale s povprečnim časom povrnitve spontanega krvnega obtoka. Zaključki: Začetne vrednosti kapilarnega laktata so pri bolnikiih z zunajbolnišničnim srčnim zastojem (OHCA) statistično pomembno višje pri bolnikih z inicialnim nešokabilnim ritmom. Prav tako so povprečne vrednosti kapilarnega laktata višje pri bolnikih z ROSC ob času povrnitve spontanega krvnega obtoka.
Keywords:kardipulmonalno oživljanje, izvenbolnišnični srčni zastoj, laktat, povrnitev spontanega krvnega obtoka
Place of publishing:Maribor
Publisher:[V. Vujanović]
Year of publishing:2025
PID:20.500.12556/DKUM-91672 New window
UDC:616.12-008.315-083.98:612.11+547.472.3(043.3)
COBISS.SI-ID:253977603 New window
Publication date in DKUM:21.10.2025
Views:168
Downloads:29
Metadata:XML DC-XML DC-RDF
Categories:MF
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Licences

License:CC BY-NC-ND 4.0, Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International
Link:http://creativecommons.org/licenses/by-nc-nd/4.0/
Description:The most restrictive Creative Commons license. This only allows people to download and share the work for no commercial gain and for no other purposes.
Licensing start date:25.01.2025

Secondary language

Language:English
Title:Dynamics of Capillary Lactate Levels in Patients with Out-of-Hospital Cardiac Arrest
Abstract:Background: The foundation of effective cardiopulmonary resuscitation is the establishment of the best possible tissue perfusion. Aim of this study was to determine the relationship between capillary lactate values, initial rhythm and the probability of restoration of spontaneous blood circulation in patients with out-of-hospital cardiac arrest. Methods: This study included all out-of-hospital non-traumatic cardiac arrest patients older than 18 years who were resuscitated by the prehospital emergency medical team between April 2020 and June 2021. Capillary lactate samples were collected on arrival and at 10-minute intervals after the first measurement until the moment of return of spontaneous blood circulation (ROSC) or, if ROSC has not been achieved, in at the time of declaration of death at the scene. Results: 83 patients were included in the study. ROSC was achieved in 28 patients (33.7%), 21 were admitted to the hospital (26.3%), and 6 (7.23%) were discharged from the hospital. Initial values of capillary lactate were significantly higher in patients with non-shockable rhythm compared to the group with shockable rhythm (9.19 ± 4.6 vs. 6.43 ± 3.81; p = 0.037). A significant difference between groups also existed in the second sample taken 10 minutes after baseline (10.03 ± 5.19 vs. 5.18 ± 3.47; p = 0.019). Mean values of capillary lactate were higher in the group with ROSC compared to the group without ROSC (11.10 ± 6.59 and 6.77 ± 4.23, respectively; p = 0.047) and coincided with the mean time to recovery of spontaneous blood circulation. Conclusions: Capillary lactate values in patients with out-of-hospital cardiac arrest (OHCA) are statistically significantly higher in patients with an initial non-shockable rhythm. Mean values of capillary lactate are also higher in patients with ROSC at the time of recovery of spontaneous blood circulation.
Keywords:cardiopulmonary resuscitation, out-of-hospital cardiac arrest, lactate, return of spontaneous circulation


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