Study On The Impacts Of Early Fluid Therapy On Perioperative Hyperlactatemia Patients In ICU

Objective: The paper is to discuss the clinical significance of early fluid therapy in fluid management of ICU perioperative hyperlactatemia patients.Method: A total 76 perioperative hyperlactatemia patients who were admitted in the Intensive Care Unit(ICU)of the Fourth Hospital of Hebei Medical University from January 2014 to December 2015,were enrolled.The patients were randomly divided into the early fluid therapy group(the Early Fluid Group;n=38)and the routine fluid therapy group(the Control Group;n=38).By analyzing Lac levels 0h,6h,24 h,48h and 72 h as well as administer ed fluid volumes 6h,24 h,48h and 72 h after admission of ICU,occurrence of acute kidney injury(AKI),administration of vasoactive agents,duration of mechanical ventilation,ICU admission duration and other indexes between the two groups,profiles of two regimes were evaluated.Results:1 General clinical profiles,including age,gender,weight,APACHE II score,surgical procedure,duration of operation,central venous pressure and arterial blood lactate(Lac)when entering ICU,and others show no statistically significant differences between the two groups,suggesting the comparability of the two groups.2 The fluid volume at 6h is higher in the Early Fluid Group(2446±242ml)than the Control Group(1745 ± 224ml),suggesting statistically significant difference(P<0.001).The fluid volumes at 24 h,48h and 72 h are 3462±326ml,6142±486ml and 8520±542ml in the Early Fluid Group and 3586 ± 342 ml,6256 ± 446 ml and 8728 ± 564 ml in the Control Group,showing no significant differences(P>0.05).3 The Lac levels at 6h and 24 h in the Early Fluid Group are significantly lower than the Control Group(P=0.009,P=0.023);while the differences of Lac profiles at 0h,48 h and 72 h between the Early Fluid Group and the Control Group show no statistical significances(P>0.05).4 The occurrence rate of AKI in the Early Fluid Group is significantly lower than the Control Group(13.16% vs.34.21%,P=0.031).The proportion of administering vasoactive agents is lower in the Early Fluid Group(13.16%)than the Control Group(21.05%),showing to statistically significant difference(P=0.361).The duration of mechanical ventilation and ICU admission duration are(32.5±12.3h)and(4.2±2.6d)in the Early Fluid Group and(30.2±14.6h)and(4.6±2.4d)in the Control Group,showing no statistical significance(P>0.05).Conclusion: With respect to management of fluid therapy for perioperative hyperlactatemia patients in ICU,early fluid therapy reduces occurrence of AKI and shortens duration of hyperlactatemia,showing superiorities over routine fluid therapy.