Lactic Acid Metabolic Disturbance And Coagulation Dysfunction In Critical Illness

Objective：To discuss the relationship between the changs of arterial bloodlactate level and coagulation functions in critical children,and to studythe correlation between above two and PCIS．Methods：80critical children with hyperlactacidemia and coagulationdisorders were studied．1.The critical children were divided into3groups by PCIS (＞80points，80to71points，≤70points， respectively) to comparedifferences of mortality,incidence of shock and MODS.2.The critical children divided into3groups by PCIS werecompared differences of PICU lactic acid level,peak lactic acidlevel,APTT,TT,DD,FBG,PLT.3.According to LAC,80critical children were divided into threegroups:（2to10mmol/L,＞10mmol/L）． Changes of coagulation markers were compared and the relationship between the above indicators wasanalyzed.4.To calculate the multiple linear regressive equation.Results：1.With decreased PCIS，the incidence of shock and MODSincreased subsequently.2.With decreased PCIS,PICU lactic acid level,peak lactic acidlevel,PT,APTT,TT increased significantly,FBG decreasedsignificantly.There were significant linear correlation between PICU lacticacid level,PT,APTT,TT,FBG and PCIS respectively(r=-0.602、-0.646、-0.658，-0.602、0.497，P<0.01).3.With increased LAC,PT,APTT,TT increased significantly,FBGdecreased significantly,differences had statisticalsignificance(P<0.05).There were significant linear correlation between PT，APTT,TT,FBG and LAC respectively(r=0.388,0.433,0.415,-0.336，P<0.01).4.Multiple linear regressive equation:PCIS=89.582-0.043PT-0.061APTT-0.078TT+2.551FBG-0.679LAC.Conclusion：PCIS not only could assess the critical children’s critical degree butalso had a significant linear correlation with lactic acid level andcoagulation function，all of which prompted the important value of blood lactic acid level and coagulation function in the prognosis evaluation ofcritical patients.Tissue hypoxia and dysfunctions of coagulation affectedeach other．Early correcting inadequate tissue perfusion might improve thefunctions of coagulation in critical children．At the same time，improvingthe functions of coagulation might raise tissue oxygen supply in criticalchildren．...