Correlations between serum lactate and intolerance of enteral nutrition in shock patients
YU Qing1, MAO Zhi2, CHEN Jinming1, YANG Bin3, HU Pan2, XUE Chao2, ZHOU Feihu2
1.Department of Critical Care Medicine,Chifeng Municipal Hospital, Chifeng 024000,China; 2. Department of Critical Care Medicine,Chinese PLA General Hospital, Beijing 100853, China; 3. Department of Cardiothoracic Surgery, Hospital 163 of PLA, Changsha Hunan 410003, China
Abstract：Objective To assess the correlations between serum lactate and intolerance of enteral nutrition(EN) in shock patients.Methods A retrospective study was conducted based on the review of medical records of ICU patients treated between January 1, 2015 and January 1, 2018. Shock patients who had received vasopressors and EN were included. Patients with a gastric residual volume ＞250 ml, vomiting, abnormalities in abdominal X ray or CT scan, intestinal ischemia or perforation were assigned to the intolerance group, and the rest to the tolerance group. The vasopressor dose, serum lactate level, EN amount and speed were recorded in both groups. The association of serum lactate with intolerance of enteral nutrition(EN) in shock patients was investigated.Results Among the 146 patients who had received EN and Ⅳ vasopressor therapy,114 were in the tolerance group, whereas 32 were in the intolerance group. The Acute Physiology and Chronic Health EvaluationⅡScores (APACHEⅡ), Sequential Organ Failure Assessment Scores(SOFA) and the maximum vasopressor dose of patients in the intolerance group were not significantly different from those of the tolerance group(P＞0.05). However, both the serum lactate level(P<0.001) and Acute Gastrointestinal Injury grade (AGI grade) (P＜0.001)of patients in the intolerance group were significantly higher than those in the tolerance group. Multiple regression analysis showed that an increased serum lactate level(＞2.0 mmol/L) was an independent predictor of EN intolerance[OR,6.8;95%CI(2.9-16.0)].Conclusions In patients with shock, the increased lactate level may predict the risk of EN intolerance.
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2020, Vol. 31 
