Does reduced oxygen delivery cause lactic acidosis in falciparum malaria? An observational study

Autor: Kingston, H, Ghose, A, Rungpradubvong, V, Herdman, T, Plewes, K, Ishioka, H, Leopold, S, Maude, R, Intharabut, B, Mohanty, S, Day, N, White, N, Hossain, M, Anstey, N, Dondorp, A
Jazyk: angličtina
Rok vydání: 2019
Předmět:
Zdroj: Malaria Journal
Malaria Journal, Vol 18, Iss 1, Pp 1-7 (2019)
ISSN: 1475-2875
Popis: BACKGROUND: Lactic acidosis with an elevated lactate-pyruvate ratio suggesting anoxia is a common feature of severe falciparum malaria. High lactate levels are associated with parasitized erythrocyte sequestration in the microcirculation. To assess if there is an additional contribution to hyperlactataemia from relatively inadequate total oxygen delivery, oxygen consumption and delivery were investigated in patients with malaria. METHODS: Adult Bangladeshi and Indian patients with uncomplicated (N = 50) or severe (N = 46) falciparum malaria or suspected bacterial sepsis (N = 27) and healthy participants as controls (N = 26) were recruited at Chittagong Medical College Hospital, Chittagong, Bangladesh and Ispat General Hospital, Rourkela, India. Oxygen delivery (DO2I) was estimated from pulse oximetry, echocardiographic estimates of cardiac index and haematocrit. Oxygen consumption (VO2I) was estimated by expired gas collection. RESULTS: VO2I was elevated in uncomplicated median (IQR) 185.1 ml/min/m2 (135-215.9) and severe malaria 192 ml/min/m2 (140.7-227.9) relative to healthy persons 107.9 ml/min/m2 (69.9-138.1) (both p CONCLUSIONS: Reduced total oxygen delivery is not a major contributor to lactic acidosis in severe falciparum malaria.
Databáze: OpenAIRE
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