Correlation of Esmolol combined with Milinone on blood lactate clearance and residual alkaline level in patients with septic shock

doi:10.3877/cma.j.issn.1674-1358.2017.05.008

Abstract

Abstract:

Objective

To investigate the clinical efficacy of Esmolol combined with Milinone in the treatment of septic shock.

Methods

Total of 102 cases of septic shock treated in our hospital from February 2010 to October 2015 were collected and randomly divided into two groups as treatment group (63 cases) and control group (39 cases). The evaluation criteria of blood lactate clearance rates and alkaline residual index were compared, respectively.

Results

Mean arterial pressure, cardiac index, systemic vascular resistance index and central venous pressure had no significant differences in the two groups of patients during treatment. However, blood lactate concentrations were gradually decreased in the treatment group and the control group, and the treatment group decreased more significantly in treatment group (t = 2.41, P = 0.02). Moreover, the lactate clearance rates in the treatment group of each time period after treatment were significantly higher than the control group (all P < 0.05).

Conclusions

The patients with septic shock often have significant metabolic acidosis such as elevated arterial blood lactate levels and alkaline residual decrease, and Esmolol plus Milinone could alleviate these conditions to some extent. The arterial lactate clearance rate and the residual alkali as serological indicators are of prognostic significance.

Key words: Esmolol, Milinone, Blood lactate, Alkali residual

Zhentao Xiao, Ling Zuo, Guoqing Zhang, Shaoliang Nie. Correlation of Esmolol combined with Milinone on blood lactate clearance and residual alkaline level in patients with septic shock[J]. Chinese Journal of Experimental and Clinical Infectious Diseases(Electronic Edition), 2017, 11(05): 464-467.

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References 25

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组别		例数	心率（次/min）	平均动脉压（mmHg）	心指数[L·min^-1·（m²）^-1]
治疗组		63
	0 h		138.6 ± 23.4	72.1 ± 11.2	2.6 ± 0.7
	2 h		111.2 ± 15.6	67.4 ± 14.2	2.6 ± 0.5
	3 h		105.3 ± 12.0	72.3 ± 15.1	3.1 ± 0.6
	4 h		104.1 ± 11.2	72.6 ± 12.7	2.4 ± 0.3
对照组		39
	0 h		132.3 ± 12.3	71.2 ± 13.4	2.2 ± 0.1
	2 h		131.2 ± 14.2	71.2 ± 13.1	2.6 ± 0.2
	3 h		130.1 ± 12.6	71.2 ± 11.0	2.7 ± 0.4
	4 h		131.5 ± 12.3	71.2 ± 11.2	2.3 ± 0.6
组别		例数	每搏指数（ml/m²）	体循环阻力指数[kPa·s/（L·m²）]	中心静脉压（mmHg）
治疗组		63
	0 h		16.2 ± 4.8	216.5 ± 83.1	16.5 ± 4.2
	2 h		30.2 ± 7.6	211.2 ± 74.2	11.9 ± 4.2
	3 h		33.2 ± 11.1	190.7 ± 71.8	11.3 ± 3.6
	4 h		31.9 ± 10.2	191.4 ± 72.8	13.5 ± 2.6
对照组		39
	0 h		15.1 ± 2.2	221.3 ± 80.5	17.1 ± 5.8
	2 h		15.1 ± 3.7	208.1 ± 61.2	16.1 ± 6.1
	3 h		17.4 ± 3.1	211.1 ± 59.1	12.2 ± 3.1
	4 h		18.2 ± 3.1	202.7 ± 52.7	12.4 ± 5.6

组别		例数	心率（次/min）	平均动脉压（mmHg）	心指数[L·min^-1·（m²）^-1]
治疗组		63
	0 h		138.6 ± 23.4	72.1 ± 11.2	2.6 ± 0.7
	2 h		111.2 ± 15.6	67.4 ± 14.2	2.6 ± 0.5
	3 h		105.3 ± 12.0	72.3 ± 15.1	3.1 ± 0.6
	4 h		104.1 ± 11.2	72.6 ± 12.7	2.4 ± 0.3
对照组		39
	0 h		132.3 ± 12.3	71.2 ± 13.4	2.2 ± 0.1
	2 h		131.2 ± 14.2	71.2 ± 13.1	2.6 ± 0.2
	3 h		130.1 ± 12.6	71.2 ± 11.0	2.7 ± 0.4
	4 h		131.5 ± 12.3	71.2 ± 11.2	2.3 ± 0.6
组别		例数	每搏指数（ml/m²）	体循环阻力指数[kPa·s/（L·m²）]	中心静脉压（mmHg）
治疗组		63
	0 h		16.2 ± 4.8	216.5 ± 83.1	16.5 ± 4.2
	2 h		30.2 ± 7.6	211.2 ± 74.2	11.9 ± 4.2
	3 h		33.2 ± 11.1	190.7 ± 71.8	11.3 ± 3.6
	4 h		31.9 ± 10.2	191.4 ± 72.8	13.5 ± 2.6
对照组		39
	0 h		15.1 ± 2.2	221.3 ± 80.5	17.1 ± 5.8
	2 h		15.1 ± 3.7	208.1 ± 61.2	16.1 ± 6.1
	3 h		17.4 ± 3.1	211.1 ± 59.1	12.2 ± 3.1
	4 h		18.2 ± 3.1	202.7 ± 52.7	12.4 ± 5.6

组别		例数	血乳酸浓度（mmol/L）	乳酸清除率（%）	碱剩余（mmol/L）
治疗组		63
	0 h		5.56 ± 1.03	—	-11.21 ± 0.58
	6 h		3.99 ± 0.67	31.64 ± 2.11	-5.12 ± 0.53
	12 h		2.36 ± 0.53	37.45 ± 2.81	-1.08 ± 0.42
	24 h		1.42 ± 0.29	40.14 ± 3.12	1.31 ± 0.32
	48 h		1.22 ± 0.38	26.22 ± 2.745	4.01 ± 0.22
对照组		39
	0 h		7.16 ± 1.66	—	-14.21 ± 1.01
	6 h		6.45 ± 1.28	5.12 ± 1.22	-12.37 ± 1.14
	12 h		6.56 ± 1.12	8.36 ± 1.28	-9.76 ± 0.87
	24 h		5.88 ± 0.67	7.64 ± 1.36	-9.24 ± 0.28
	48 h		6.11 ± 0.87	-1.79 ± 0.59	-11.32 ± 0.63

组别		例数	血乳酸浓度（mmol/L）	乳酸清除率（%）	碱剩余（mmol/L）
治疗组		63
	0 h		5.56 ± 1.03	—	-11.21 ± 0.58
	6 h		3.99 ± 0.67	31.64 ± 2.11	-5.12 ± 0.53
	12 h		2.36 ± 0.53	37.45 ± 2.81	-1.08 ± 0.42
	24 h		1.42 ± 0.29	40.14 ± 3.12	1.31 ± 0.32
	48 h		1.22 ± 0.38	26.22 ± 2.745	4.01 ± 0.22
对照组		39
	0 h		7.16 ± 1.66	—	-14.21 ± 1.01
	6 h		6.45 ± 1.28	5.12 ± 1.22	-12.37 ± 1.14
	12 h		6.56 ± 1.12	8.36 ± 1.28	-9.76 ± 0.87
	24 h		5.88 ± 0.67	7.64 ± 1.36	-9.24 ± 0.28
	48 h		6.11 ± 0.87	-1.79 ± 0.59	-11.32 ± 0.63

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