Associação entre níveis séricos de lactato e síndrome de realimentação em pacientes críticos
DOI:
https://doi.org/10.12873/451arteagaPalavras-chave:
Lactato, Síndrome de realimentação, Pacientes críticos, Unidade de cuidados intensivosResumo
Objetivo: Analisar a relação entre os níveis de lactato sanguíneo e o desenvolvimento da síndrome de realimentação (SR) em pacientes críticos. Métodos: Este estudo de coorte prospectivo incluiu pacientes com 18 anos ou mais que foram admitidos na unidade de terapia intensiva (UTI) do Hospital Clínica San Francisco por pelo menos 48 horas entre janeiro e junho de 2019. A SR foi definida como uma diminuição de 30% no fósforo sérico dentro de 48 horas após o início do suporte nutricional. Lactato sérico, SOFA, APACHE II, risco nutricional e estado nutricional foram medidos na admissão na UTI. As análises estatísticas foram conduzidas usando o teste t de Student, o teste U de Mann-Whitney e o teste de Wilcoxon. Resultados: Um total de 141 pacientes foram selecionados, com 53,8% (n = 83) sendo do sexo masculino, e 34,8% (n = 49) desenvolveram SR. Os diagnósticos primários foram sepse e condições neurocríticas, com uma taxa de mortalidade geral de 18,4%. Entre os pacientes com SR, 85,7% (n = 41) foram identificados como tendo risco nutricional na admissão, e 53,1% (n = 26) tinham desnutrição moderada. Pacientes com SR tiveram estadias mais longas na UTI (12 vs. 7 dias, p = 0,006) e estadias mais longas no hospital (22 vs. 15 dias, p = 0,007) em comparação com aqueles sem SR. Pacientes com SR tiveram níveis de lactato sérico significativamente mais altos em comparação com aqueles sem SR (1,62 vs. 2,14 mmol/l; p = 0,002). Conclusões: No presente estudo, o nível de lactato sérico está associado ao desenvolvimento de RFS em pacientes gravemente enfermos.
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