J Korean Soc Emerg Med.  2017 Dec;28(6):659-664. 10.0000/jksem.2017.28.6.659.

Efficacy of Initial Lactate and Lactate Clearance by Emergency Department Treatment in Diabetic Ketoacidosis Patients

Affiliations
  • 1Department of Emergency Medicine, Soonchunhyang University Cheonan Hospital, Soonchunhyang University College of Medicine, Cheonan, Korea. yisfm83@gmail.com
  • 2Department of Emergency Medicine, Soonchunhyang University Gumi Hospital, Soonchunhyang University College of Medicine, Gumi, Korea.

Abstract

PURPOSE
Diabetic ketoacidosis (DKA) is a fatal complication caused by unregulated diabetes. Lactate is used as a prognostic indicator for a range of serious illnesses and its level is higher in DKA patients. This study examined the utility of lactate and lactate clearance measurements at an emergency department for predicting the prognosis of DKA patients.
METHODS
This was a retrospective, observational study of patients with DKA presenting to the emergency department of an urban and rural tertiary hospital between January, 2013 and December, 2016. The demographic and laboratory data were collected through a chart review.
RESULTS
Seventy-six patients with DKA were included. Of these 76 patients, 46 (56.8%) had lactic acidosis (lactate >2.5 mmol/L) and 24 (29.6%) had a high lactate level (>4 mmol/L). Lactate and lactate clearance showed a significant difference in terms of the intensive care unit length of stay and mortality.
CONCLUSION
Lactate and lactate clearance measurements in DKA patients are favorable and significant prognostic factors. In DKA patients, serial measurements of lactate should be considered.

Keyword

Diabetic ketoacidosis; Lactic acid; Prognosis

MeSH Terms

Acidosis, Lactic
Diabetic Ketoacidosis*
Emergencies*
Emergency Service, Hospital*
Humans
Intensive Care Units
Lactic Acid*
Length of Stay
Mortality
Observational Study
Prognosis
Retrospective Studies
Tertiary Care Centers
Lactic Acid
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