Lactato como indicador de otras complicaciones maternas en pacientes con diagnóstico de preclamsia severa
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Fecha
2022
Autores
Sallas Rodríguez, Erick Enrique
Ávila Mass, Juan José
Franco Hernández, Gustavo Adolfo
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Ediciones Universidad Simón Bolívar
Facultad de Ciencias de la Salud
Facultad de Ciencias de la Salud
Resumen
Los trastornos hipertensivos del embarazo, en los países en vías de desarrollo, son una causa importante de morbilidad y en algunos casos de mortalidad materna. Es por ello por lo que se han buscado marcadores para monitorear la evolución de la paciente obstétrica, uno de ellos ha sido el lactato, en diferentes puntos de corte, el punto de mayor aceptación es el de 2.4mmol/L.
Objetivo: Determinar la asociación de niveles elevados de lactato con punto de cohorte de 2.4 mmol/L como un marcador pronóstico de complicaciones maternas tempranas en pacientes en pacientes obstétricas ingresadas a la UCI.
Metodología: se realiza un estudio de tipo analítico, retrospectivo, cuantitativo. Donde se revisaron las historias clínicas de pacientes obstétricas, registrándose los valores de las Edad, motivo de remisión a UCI, niveles de Lactato, Función Renal, Función Hepática, niveles de presión arterial, así como química sanguínea y hemograma básico y el tipo de complicación materna parte de la preclamsia severa.
Resultados: Se evaluaron un total de 98 pacientes, con edad promedio de 25 IC 14 – 40 años. El principal motivo de remisión a UCI fueron las Cifras tensionales elevadas (47%), seguido de síntomas ominosos (46,24%). El promedio del Lactato fue de 1.7±0.90. el 11.5% de las pacientes estuvieron iguales o por encima de 2.4mmol/L. La edad estuvo asociada con los niveles altos de lactato (p: 0.0009). Para la función renal, el lactato alto se asoció con la proteinuria alta (p: 0.0152). Así mismo los niveles de Lactato por encima de 2.4mmol/L tenían niveles mayores de Alanina aminotransferasa (ALT) (p: 0.0410) y la otra fue Lactato deshidrogenasa (LDH) (p: 0.0410). En el caso de las complicaciones maternas, el grupo con lactato mayor a 2.4mmol/L se asoció con la presencia de al menos una comorbilidad en general (p: 0.0458).
Conclusiones: El lactato es un indicador correlacionado con la edad de la paciente obstétrica, puede utilizarse para indicador indirecto ya que sus niveles se relacionan con la proteinuria alta y podría utilizarse como indicador de la aparición de una segunda complicación materna, independiente de la preclamsia.
Hypertensive disorders of pregnancy, in developing countries, are an important cause of morbidity and in some cases of maternal mortality. That is why markers have been sought to monitor the evolution of the obstetric patient, one of them has been lactate, at different cut-off points, the point of greatest acceptance being 2.4mmol/L. Objective: To determine the association of elevated lactate levels with a cohort point of 2.4 mmol/L as a prognostic marker of early maternal complications in obstetric patients admitted to the ICU. Methodology: an analytical, retrospective, quantitative study is carried out. Where the medical records of obstetric patients were reviewed, registering the values of age, reason for referral to the ICU, lactate levels, kidney function, liver function, blood pressure levels, as well as blood chemistry and basic blood count and the type of complication. maternal part of severe preeclampsia. Results: A total of 98 patients were evaluated, with a mean age of 25 CI 14 - 40 years. The main reason for remission to the ICU was high blood pressure figures (47%), followed by ominous symptoms (46,24%). The average lactate was 1.7±0.90. 11.5% of the patients were equal to or above 2.4mmol/ L. Age was associated with high lactate levels (p: 0.0009) For renal function, high lactate was associated with high proteinuria (p: 0.0152) Likewise, lactate levels above 2.4mmol/ L had higher levels of Alanine aminotransferase (ALT) (p: 0.0410) and the other was Lactate dehydrogenase (LDH) (p: 0.0410).In the case of maternal complications, the group with lactate greater than 2.4mmol/L was associated with the presence of at least one comorbidity in general (p: 0.0458). Conclusions: Lactate is an indicator correlated with the age of the obstetric patient, it can be used as an indirect indicator since its levels are related to high proteinuria and could be used as an indicator of the appearance of a second maternal complication, independent of preeclampsia.
Hypertensive disorders of pregnancy, in developing countries, are an important cause of morbidity and in some cases of maternal mortality. That is why markers have been sought to monitor the evolution of the obstetric patient, one of them has been lactate, at different cut-off points, the point of greatest acceptance being 2.4mmol/L. Objective: To determine the association of elevated lactate levels with a cohort point of 2.4 mmol/L as a prognostic marker of early maternal complications in obstetric patients admitted to the ICU. Methodology: an analytical, retrospective, quantitative study is carried out. Where the medical records of obstetric patients were reviewed, registering the values of age, reason for referral to the ICU, lactate levels, kidney function, liver function, blood pressure levels, as well as blood chemistry and basic blood count and the type of complication. maternal part of severe preeclampsia. Results: A total of 98 patients were evaluated, with a mean age of 25 CI 14 - 40 years. The main reason for remission to the ICU was high blood pressure figures (47%), followed by ominous symptoms (46,24%). The average lactate was 1.7±0.90. 11.5% of the patients were equal to or above 2.4mmol/ L. Age was associated with high lactate levels (p: 0.0009) For renal function, high lactate was associated with high proteinuria (p: 0.0152) Likewise, lactate levels above 2.4mmol/ L had higher levels of Alanine aminotransferase (ALT) (p: 0.0410) and the other was Lactate dehydrogenase (LDH) (p: 0.0410).In the case of maternal complications, the group with lactate greater than 2.4mmol/L was associated with the presence of at least one comorbidity in general (p: 0.0458). Conclusions: Lactate is an indicator correlated with the age of the obstetric patient, it can be used as an indirect indicator since its levels are related to high proteinuria and could be used as an indicator of the appearance of a second maternal complication, independent of preeclampsia.
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Palabras clave
Preeclampsia, Lactato, Embarazo de alto riesgo, UCI Obstétrica, Lactate, High-risk pregnancy, Obstetric ICU