Meta AnalysisID 2349

药物治疗及人类疾病相关的乳酸性酸中毒

CRD42022363623

The aim of this narrative review is to revise the scientific literature for further confirmation about the importance of early identification of acidotic statuses and to underline how an early diagnosis can prevent the w

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Record Fields

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Meta Analysis Id
2349
Evidence Id
10907
Core Evidence Id
10907
Source Meta Analysis Id
2296
Herb2 Meta Analysis Id
HBMA002296
Crd Id
CRD42022363623
Title
Lactic Acidosis related to pharmacotherapy and human illness
Review Question
The aim of this narrative review is to revise the scientific literature for further confirmation about the importance of early identification of acidotic statuses and to underline how an early diagnosis can prevent the worst clinical outcome.
Study Type Included
clinical trials, meta-analysis, randomized controlled trials (RCT), review, and systematic review.
Condition Being Studied
Lactic acidosis development represents one of the most common condition that can compromise the health of intensive care unit (ICU) patients. Generally, increased levels of serum lactic acid could be due to numerous factors including hypoxia (caused for example by septic/cardiogenic/hypovolemic or obstructive shock), specific pathologies (e.g. liver disease), use of some drugs (e.g. metformin), presence of toxins and trauma experience.
Participant
patients in ICU (intensive Care Unit)
Animal
Human Disease Modelled
Intervention
There are two enantiomers of Lactic acid: L-Lactic Acid and D-Lactic Acid. The first one is associated with a large increase in mortality: it is directly correlated with the blood lactate level and it is an indicator of unbalanced glucose metabolism. If the concentration of L-Lactic Acid becomes too high leading to a state of severe acidemia, the main risk is cardiovascular collapse. D-Lactic Acid is produced in the human organism by microbiota and while its synthesis is controlled under normal circumstances, it increases in clinical conditions such as short bowel syndrome and jejunoileal bypass surgery. Since infectious and inflammatory-related diseases can also cause or be associated with increased D-Lactate level, D-Lactate can be used as a marker of some infections and sepsis.
Comparator Control
Two groups of patients with L- or D-acid lactic acidosis; complications that these two groups of patients develop
Main Outcome
The accumulation of Lactate and protons in the body fluids leading to a state of L-Lactic acidosis can result into a poor clinical outcome. In this review, we saw that an early diagnosis can help to improve the chances of survival, allowing an early treatment (both targeted to the primary cause but also, when needed, focused on the resuscitation). On the diagnose side, one of the main challenges is the early distinction between D-Lactic acidosis and L-Lactic acidosis but also the distinction between true hyperlactatemia or a cross reaction of the reagents with the metabolites. Therapies have their solid base in the primary treatment of the cause (withdrawal of the drugs that increase L-Lactic acid levels, treatment of sepsis, cardiovascular treatments etc.) and the support of tissue perfusion. Future possibilities in targeted therapies are the inhibition of the NHE1 exchanger to reduce the damage of cells and MCT lactate transporters in L-Lactic acidosis that are tumor-induced.
Outcome Measure
Additional Outcome
Study Method
Systematic review
Keyword
Acidosis, Lactic; Early Diagnosis; Humans; Lactates
Contact
TATSIANA ROMENSKAYA [email protected]
Organisational Affiliation
Department of Anesthesia and Critical Care Medicine, Azienda Ospedaliera SS Antonio e Biagio e C. Arrigo, Alessandria, Italy https://www.ospedale.al.it
Funding Source
no sponsors
Other Selection Criteria
Final Publication
Same Topic Review
Published Protocol
Review Type
Language
English
Country
Italy
Review Stage
Review Ongoing
First Submission Date
2022-09-29
Registration Date
2022-10-10
Anticipated Start Date
2022-04-01
Anticipated Completion Date
2022-10-30
Title Cn
药物治疗及人类疾病相关的乳酸性酸中毒
Title En
Lactic Acidosis related to pharmacotherapy and human illness
Bilingual Status
complete