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응급실로 내원한 산후 출혈 환자의 중증도 예측 인자로서 젖산 농도의 유용성

Other Titles
 The usefulness of lactate as an early predictor of the severity of emergency department patients with postpartum hemorrhage 
Authors
 조영준  ;  유제성  ;  정성필  ;  좌민홍  ;  공태영  ;  고동률  ;  황윤정  ;  이용희  ;  박인철  ;  김시내 
Citation
 Journal of the Korean Society of Emergency Medicine (대한응급의학회지), Vol.30(1) : 33-43, 2019 
Journal Title
 Journal of the Korean Society of Emergency Medicine (대한응급의학회지) 
ISSN
 1226-4334 
Issue Date
2019
Keywords
Postpartum hemorrhage ; Prognosis ; Lactic acid
Abstract
Objective: Only a few studies have examined the role of lactate reflecting on tissue hypoperfusion determining the severity of postpartum hemorrhage (PPH) patients in the emergency department (ED). This study evaluated the utility of the arterial lactate level as a prognostic marker of severity in PPH patients admitted to an ED. Method: This retrospective, observational cohort study was conducted on patients integrated prospectively in a critical pathway of SPEED (Severance Protocol to save postpartum bleeding through Expeditious care Delivery). Adult primary PPH patients admitted to the ED between July 1, 2010 and March 31, 2017 were analyzed. The outcomes were the development of severe PPH including death, hysterectomy, surgical treatment, and massive transfusion. Results: A total of 112 patients were enrolled in this study. An increase in the arterial lactate value was a strong independent predictor of severe PPH. The increasing predictability of severe PPH was closely associated with an arterial lactate ≥3.15 mL/L at admission (odds ratio, 13.870; P<0.001). Conclusion: Lactate is an independent predictor of severe PPH and is suitable for a rapid and simple estimation of the severity of PPH. Emergency physicians can use lactate to determine the initial treatment strategies more precisely.
Files in This Item:
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Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Emergency Medicine (응급의학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Yonsei Biomedical Research Center (연세의생명연구원) > 1. Journal Papers
Yonsei Authors
Ko, Dong Ryul(고동률) ORCID logo https://orcid.org/0000-0002-3098-2784
Kong, Tae Young(공태영) ORCID logo https://orcid.org/0000-0002-4182-7245
Kim, Si Nae(김시내)
Park, In Cheol(박인철) ORCID logo https://orcid.org/0000-0001-7033-766X
You, Je Sung(유제성) ORCID logo https://orcid.org/0000-0002-2074-6745
Chung, Sung Pil(정성필) ORCID logo https://orcid.org/0000-0002-3074-011X
Cho, Young Joon(조영준)
Choa, Min Hong(좌민홍) ORCID logo https://orcid.org/0000-0003-0338-994X
Hwang, Yoon Jung(황윤정) ORCID logo https://orcid.org/0000-0001-7286-7699
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/170975
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