The Relationship Between Serum Lactate levels and Intubation in Patients with COPD Exacerbation Presenting to the Emergency Room at Maharat Nakorn Ratchasima Hospital.
Keywords:
AECOPD, Lactate, Endotracheal Intubation, Emergency Department, Respiratory FailureAbstract
This study aimed to evaluate the association between serum lactate levels and the requirement for endotracheal intubation among patients presenting with AECOPD. This prospective cohort study included AECOPD patients presenting to the emergency department. Serum lactate was measured prior to bronchodilator therapy. Clinical characteristics and laboratory data were recorded, and patients were followed to determine the need for endotracheal intubation within 24 hours of presentation. Lactate levels were log-transformed due to right-skewed distribution. Logistic regression analysis was performed to evaluate the association between lactate levels and intubation. Receiver operating characteristic (ROC) curve analysis was conducted to assess discriminatory performance and to identify the optimal cutoff value.
Results: Patients requiring intubation had significantly higher lactate levels (p < 0.01). Lactate level was independently associated with intubation (p < 0.01). Every doubling of the serum lactate level was associated with a 2.79-fold increase in the odds of endotracheal intubation. A serum lactate level > 1.6 mmol/L predicted endotracheal intubation with 78% sensitivity and 51% specificity.
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