The Clinical Significance Of The Blood Lactate And Lactate Clearance Rate In The Treament Of Type ? Respiratory Failure

Objective: To investigate the clinical significance of the blood lactate and lactate clearance rate in the treatment of type II respiratory failure. Methods: 92 patients with type II respiratory failure who were hospitalized in the Pneumology Department of the first people's Hospital of Lanzhou from December 2013 to December 2014 were collected for research, they are 40 to 90 years old, the average age is(68.39±9.38)years. All cases were consistent with the diagnostic criteria of type II respiratory failure. The patients?clinical datum, including the general situation and the relevant examination, were integrated. After anti infection, anti-inflammatory, asthma, phlegm, bronchial dilation and noninvasive ventilation treatments, the patients were divided into survival group and death group according to the final outcome. Recorded the arterial blood LAC and duration of LAC>2 mmol/L of patients on admission and 6h ?24h ?48h ?72h after admission, and the LCR were calculated on 6h,24 h. Then the LAC, LCR,2PaCO,2PaO and duration of LAC>2 mmol/L were compared between two groups.Results: The difference of the LAC between the survival group and the death group there was no significant on admission(P>0.05), but on 6h, 24 h after admission, the LAC of the survival group was lower than the death group's, the difference was statistically significant(P<0.05). The LCR of the survival group was higher than the death group's on 6h and 24 h, the difference was statistically significant(P<0.05). The duration of LAC>2.0 mmol/L of the survival group was significantly shorter than the death group's, the difference was statistically significant(P<0.05). 24 hours after admission, the PaCO2 of the two groups were significantly decreased and the PaO2 increased, The differences between before and after treatment in the two groups was statistically significant(P<0.05). But the differences of PaO2 and PaCO2 between two groups were not statistically significant(P>0.05) on admission and 24 h after admission.Conclusion: LAC and LCR have important clinical significances in estimate the curative effect and prognosis of the treatment to type II respiratory failure.The more rapid declined of LAC concentration, the higher LCR is, and the curative effect and prognosis of the patients are better. On the contrary, the prognosis is worse. The sustained increase of lactic acid is harmful to the prognosis of patients. To estimate the efficacy and prognosis of patients with type II respiratory failure, in addition to according to PaCO2, PaO2, should be combined with arterial LAC and LCR.