I-Lactate: iyini nokuthi kungani ingaba phezulu

-Delile

• Kuthathwa nini ukuhlolwa kwe-lactate
• Kusho ukuthini ukuthi i-lactate ephezulu

I-Lactate ingumkhiqizo we-glucose metabolism, okungukuthi, kungumphumela wenqubo yokuguqula i-glucose ibe ngamandla wamaseli lapho ingekho i-oxygen eyanele, inqubo ebizwa nge-anaerobic glycolysis. Kodwa-ke, noma ezimeni ze-aerobic, lapho kune-oxygen, i-lactate ikhiqizwa, kepha ngamanani amancane.

I-Lactate yinto ebalulekile, njengoba ithathwa njengesiginali ku-Central Nervous System, i-biomarker yezinguquko zezinzwa nezicubu ze-hypoperfusion, lapho kunomoya omncane we-oksijini ofinyelela izicubu, nokuqina kokusebenza komzimba nokukhathala kwemisipha, kusukela kangakanani lo msebenzi uqina ngokwengeziwe, sikhulu isidingo somoya-mpilo namandla, okuholela ekukhiqizweni okukhulu kwe-lactate.

Kuthathwa nini ukuhlolwa kwe-lactate

Isivivinyo se-lactate sisetshenziswa kakhulu ekwenzeni imitholampilo ezigulini ezibhedlela nanjengesikhombisi sokuqina kokuvivinya umzimba nokukhathala kwemisipha. Ezibhedlela, umthamo we-lactate kubalulekile ukuhlola isimo esijwayelekile sesiguli futhi uqinisekise impendulo ekwelashweni. Imvamisa isilinganiso senziwa ezigulini ezibhedlela ezisolwa noma ezitholwe zine-sepsis noma i-septic shock, okuyizimo ezibonakala nge-lactate engaphezulu kwe-2 mmol / L ngaphezu komfutho wegazi ophansi, ukuphefumula okusheshayo, ukwehla kokukhiqizwa komchamo nokudideka kwengqondo.

Ngakho-ke, lapho wenza i-lactate dosing, kungenzeka ukubheka ukuthi ngabe isiguli siyasabela yini ekwelashweni noma ngabe kuyadingeka yini ukushintsha uhlelo lokwelapha nokukhulisa ukunakekelwa ngokuya ngokuncipha noma ngokwanda kwamazinga e-lactate.

Kwezemidlalo, isilinganiso se-lactate sivumela ukunquma izinga lokusebenza komsubathi namandla okuzivocavoca umzimba. Emisebenzini yomzimba enamandla kakhulu noma yesikhathi eside, inani le-oxygen elitholakalayo alihlali lanele ngaso sonke isikhathi, elidinga ukukhiqizwa kwe-lactate ukugcina ukusebenza kwamaseli. Ngakho-ke, ukukala inani le-lactate ngemuva kokuzivocavoca umzimba kuvumela uthisha womzimba ukuthi akhombise uhlelo lokuqeqesha olulungele umsubathi.

Inani le-lactate lithathwa njengelivamile uma lingaphansi noma lilingana no-2 mmol / L. Ukuphakama kokuhlushwa kwe-lactate, kukhula kakhulu isifo. Endabeni ye-sepsis, isibonelo, ukugxila kwe-4.0 mmol / L noma ngaphezulu kungatholakala, okukhombisa ukuthi ukwelashwa kufanele kuqalwe ngokushesha okukhulu ukugwema izinkinga.

Ukwenza isivivinyo se-lactate, akudingeki ukuzila ukudla, kepha kunconywa ukuthi lowo muntu aphumule, ngoba ukuvivinya umzimba kungashintsha amazinga e-lactate futhi, ngaleyo ndlela, kuthinte imiphumela yokuhlolwa.

Kusho ukuthini ukuthi i-lactate ephezulu

Ukwanda kokuhlushwa kwe-lactate ejikelezayo, ebizwa nge-hyperlactemia, kungenzeka ngenxa yokwanda kokukhiqizwa kwe-lactate, ushintsho ekunikezelweni komoya-mpilo ezicutshini noma ukushoda ekuqedweni kwalesi sakhi emzimbeni, okuholela ekutholakaleni kwaso egazini. Ngakho-ke, i-lactate ephezulu ingenzeka ngenxa ye:

• I-Sepsis nokwethuka okubucayi, lapho, ngenxa yokukhiqizwa kobuthi ngama-microorganisms, kunciphisa inani le-oxygen elifinyelela izicubu, ngokunyuka kokukhiqizwa kwe-lactate;
• Umsebenzi omkhulu womzimba, ngoba kwezinye izimo inani le-oxygen yokwenza lo msebenzi alanele, ngokwanda kokukhiqizwa kwe-lactate;
• Ukukhathala kwemisipha, ngenxa yamanani amakhulu e-lactate anqwabelene emisipheni;
• Isystemic reaction reaction syndrome (SIRS), njengoba kukhona ushintsho ekugelezeni kwegazi namaseli omzimba, okuholela ekukhuleni kokukhiqizwa kwe-lactate emzamweni wokugcina imisebenzi yamaselula nokusiza esixazululweni sokuvuvukala. Umthamo we-lactate kulesi simo usetshenziswa kakhulu ukuqapha impendulo yesiguli futhi ulinganise ubungozi bokuhluleka komzimba, okuyisibonakaliso sesibikezelo;
• Ukushaqeka kwe-Cardiogenic, lapho kukhona khona ushintsho ekunikezelweni kwegazi enhliziyweni futhi, ngenxa yalokho, i-oxygen;
• Ukushaqeka Hypovolemic, lapho kukhona ukulahleka okukhulu koketshezi negazi, kuguqula ukwabiwa kwegazi kuzicubu;

Ngaphezu kwalokho, ezinye izifundo zikhombisile ukuthi ukwanda kwe-lactate kungenzeka esimweni sezinkinga zesibindi nezinso, isifo sikashukela, ukufakwa ubuthi yizidakamizwa nobuthi kanye ne-metabolic acidosis, isibonelo. Ngakho-ke, ngokususelwa ekuhlolweni kokuhlushwa kwe-lactate, kungenzeka ukuthi kutholakale ukuxilongwa kwezifo, kuqaphe ukuvela kwesiguli nempendulo ekwelashweni kanye nokubikezela umphumela womtholampilo.