Lactate Clearance and Central Venous Oxygen Saturation in Early Sepsis

JAMA ◽  
2010 ◽  
Vol 303 (20) ◽  
pp. 2031 ◽  
Author(s):  
Bertrand Sauneuf
Author(s):  
Marc de Moya ◽  
Leandra Krowsoski

The multicenter randomized control trial of “Lactate Clearance versus Central Oxygen Saturation as Goals of Early Sepsis Therapy” compares the standard monitoring of central venous oxygen saturation (ScvO2) recommended by the Surviving Sepsis Campaign guidelines to the clearance of lactate to determine tissue perfusion and guide resuscitation. This study suggests a protocol that uses the trend of lactate throughout the initial interventions for sepsis with a goal clearance of 10% in place of ScvO2 measured via central venous catheter. When rates of in-hospital mortality, ICU length of stay, ventilator-free days, and new-onset multiple organ failure were compared between the two groups, outcomes were non-inferior with the use of lactate clearance. The results demonstrate that lactate clearance can be used in place of ScvO2 as part of a resuscitation protocol that includes quantitative goals for CVP and MAP to yield an equivalent short-term survival outcome in early sepsis.


2012 ◽  
Vol 19 (3) ◽  
pp. 252-258 ◽  
Author(s):  
Michael A. Puskarich ◽  
Stephen Trzeciak ◽  
Nathan I. Shapiro ◽  
Ryan C. Arnold ◽  
Alan C. Heffner ◽  
...  

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