Lactate clearance cut off for early mortality prediction in adult sepsis and septic shock patients

Background: Severe sepsis and septic shock are the major causes of admission and deaths in the ICU, killing one in four (and often more) and increasing in incidence. In order to improve the clinical outcomes in these patients, it is crucial to obtain early recognition of patients who are at risk of death and to optimize the clinical decision making in a timely manner. In order to monitor the metabolic consequences of shock and hemodynamic management, plasma lactate levels can be used in critical illness. Objective of the study is to estimate plasma lactate and lactate clearance in sepsis and septic shock patients and to correlate plasma lactate and lactate clearance as predictors of mortality.Methods: This study is a prospective observational study conducted over 18months. Children with age of 1 month to 18 years admitted to the Paediatric intensive care unit with sepsis and septic shock were enrolled in the study. ABG at admission to document plasma lactate and lactate repeated at 6 and 24 hrs. Lactate clearance calculated at 6 and 24 hrs. The final outcome in terms of survival or death will be recorded.Results: Majority of the children fall in the class between 1-6 months 51(48.11%). Male comprises 69(65.09%). Among these, Sepsis 36(33.96%); followed by Pneumonia 34(32.07%). Survivors group were 35(33.02%) and non-survivor was 71(66.98%). The Non survivor group was observed to have lower mean values of lactate clearance and found to be statistically significant. Specificity of Lactate clearance was 63.52% and Sensitivity 76.02% respectively. The results were positively associated with lactate level at 24 hours found to be significant effect of survivability when compared to non-survivor.Conclusions: Lactate clearance is vital and markable sign for screening of septic shock at early stage for therapeutic option. Further, 24-hours lactate estimation (cut off values) clearance appears superior to 6 h lactate clearance in predicting mortality in such patients.

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Endpoint resuscitation-based prediction model for early mortality of severe sepsis and septic shock

Critical Care ◽

10.1186/cc13252 ◽

2014 ◽

Vol 18 (Suppl 1) ◽

pp. P62

Author(s):

R Sinto ◽

S Suwarto ◽

R Sedono ◽

K Harimurti ◽

A Sejati

Keyword(s):

Septic Shock ◽

Severe Sepsis ◽

Prediction Model ◽

Early Mortality ◽

Sepsis And Septic Shock

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The Usefulness of Lactate Clearance Adjusted to Time as a Predictive Index in Patients with Severe Sepsis and Septic Shock

The Korean Journal of Critical Care Medicine ◽

10.4266/kjccm.2009.24.3.134 ◽

2009 ◽

Vol 24 (3) ◽

pp. 134 ◽

Cited By ~ 1

Author(s):

Jung-Hwan Ahn ◽

Sang-Cheon Choi ◽

Young-Gi Min ◽

Yoon-Seok Jung ◽

Sung Hee Chung ◽

...

Keyword(s):

Septic Shock ◽

Severe Sepsis ◽

Lactate Clearance ◽

Predictive Index ◽

Sepsis And Septic Shock

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Effect of Lactate and Lactate Clearance Condition on the Prognosis of Sepsis in Children

10.20944/preprints202007.0718.v1 ◽

2020 ◽

Author(s):

D M Kamrul Hasan ◽

Shafayat Hossain Evan ◽

Md Rezaul Karim ◽

Xin Yi Men ◽

Zhang Huifeng ◽

...

Keyword(s):

Septic Shock ◽

Lactate Level ◽

Poor Prognosis ◽

Vital Signs ◽

Lactate Clearance ◽

Dynamic Monitoring ◽

Outcome Variable ◽

Clinical Report ◽

Monitoring Index ◽

Sepsis And Septic Shock

Objectives: To investigate the value of early lactate dynamic monitoring index in predicting prognosis of patients with sepsis and septic shock. Methods: We performed our test on 50 patients. Out of 50 patients, 28 are male, and 22 are female. Prospectively studied pediatric patients with septic shock were performed. Vital signs, Lactate clearance, were obtained at presentation 6 h, 12 h, 24 h over the first 48 h of hospitalization. The therapy received, outcome parameters of mortality and duration of hospitalization were recorded. Results: The statistical data and comparative analysis showed that an average of 16.88 days after admission, 5 patients have died, 17 patients are poorly prognosis leaves the hospital, and the remaining 28 are recovered and discharged. The primary outcome variable of mean 16 days hospitalization mortality rate was 10%. Poor prognosis 34% and fully recovery 56 % were observed. In this retrospective cohort study, a lactate level of more than 2.5mmol/L was the best threshold to predict 28-day mortality among severe sepsis and septic shock patients. In our research, we found mean LC 6 h 3.08mmol/L, and after 48 h mean it is 1.79mmol/L. Significant LC 6 h found, which is 8.08mmol/L in the death group patient where 48 h mmol/L shows significant high. Poor prognosis also presents a clinical increase of lactate level high in the LC 6 h analysis, which is 3.32mmol/L. Recovered patients showed a significant improvement after administering treatment depending on the patient organ involvement and good decrease of lactate reports achieved, which is 1.20mmol/L, where admission reports show it was 1.91mmol/L in LC 6 h. Mean Heart rate 94/51mmhg, pulse 119, temperature 39℃, respiratory rate 32.26, and urine output 456 ml recorded during our study. Death patient shows a remarkable detonation of those reports but has a significant clinical report with the recovered patients. Conclusion: The early lactate dynamic monitoring index has a high value in predicting sepsis and septic shock patients' prognosis, thus worth popularizing.

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STUDY OF SERUM LACTATE LEVELS IN PATIENTS WITH SEPSIS ON THE BASIS OF SURVIVAL AND NON-SURVIVAL

10.36106/paripex/9800396 ◽

2021 ◽

pp. 8-10

Author(s):

Anisha Tanwar ◽

Bushra Fiza ◽

Bhupesh Medatwal ◽

Rubal Singh ◽

Maheep Sinha

Keyword(s):

Septic Shock ◽

Severe Sepsis ◽

Lactic Acid ◽

Survival Rate ◽

Lactate Concentration ◽

Serum Lactate ◽

Mortality Prediction ◽

P Value ◽

Lactate Levels ◽

Sepsis And Septic Shock

INTRODUCTION:- Sepsis is a leading cause of morbidity and mortality internationally Early spotting and . interventions are essential to ensure better patient's outcome. Lactate concentration in septic patients is of particular prognostic value in predicting septic shock and mortality. AIM:- The present study was intended to evaluate the serum Lactate levels on the basis of severity rate in patients suffering of sepsis, severe sepsis and septic shock. MATERIAL & METHOD:- 100 patients diagnosed for sepsis were enrolled for the study and they were grouped as sepsis (n=30), severe sepsis (n=37)and septic shock (n=33). On the basis of survival rate serum Lactate levels in patients with sepsis were estimated in all the 3 categories of subjects according to the inclusion criteria. A p-Value of ≤0.05 were considered as statistically significant. RESULT:- In the present study when the lactate levels were evaluated among all the three categories, it was observed that the Lactate levels were found to be statistically significant (p-value <0.0001). Lactic acid evaluated on the basis of survival rate was also found to be statistically significant with the p-Value 0.015. CONCLUSION:- Lactic acid could be utilized as a reliable marker to assess prognosis at the initial phase of presentation because its initial evaluation shows good predictability in mortality prediction in sepsis patients.

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