Comparison Of Peak Lactate Levels Between A Wingate Test And Dune Climb

Background and Objectives: Pediatric extracorporeal membrane oxygenation (ECMO) support is often the ultimate therapy for neonatal and pediatric patients with congenital heart defects after cardiac surgery. The impact of lactate clearance in pediatric patients during ECMO therapy on outcomes has been analyzed. Materials andMethods: We retrospectively analyzed data from 41 pediatric vaECMO patients between January 2006 and December 2016. Blood lactate and lactate clearance have been recorded prior to ECMO implantation and 3, 6, 9 and 12 h after ECMO start. Receiver operating characteristic (ROC) analysis was used to identify cut-off levels for lactate clearance. Results: Lactate levels prior to ECMO therapy (9.8 mmol/L vs. 13.5 mmol/L; p = 0.07) and peak lactate levels during ECMO support (10.4 mmol/L vs. 14.7 mmol/L; p = 0.07) were similar between survivors and nonsurvivors. Areas under the curve (AUC) of lactate clearance at 3, 9 h and 12 h after ECMO start were significantly predictive for mortality (p = 0.017, p = 0.049 and p = 0.006, respectively). Cut-off values of lactate clearance were 3.8%, 51% and 56%. Duration of ECMO support and respiratory ventilation was significantly longer in survivors than in nonsurvivors (p = 0.01 and p < 0.001, respectively). Conclusions: Dynamic recording of lactate clearance after ECMO start is a valuable tool to assess outcomes and effectiveness of ECMO application. Poor lactate clearance during ECMO therapy in pediatric patients is a significant marker for higher mortality.

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Effects of Beetroot Juice Supplementation on Performance and Fatigue in a 30-s All-Out Sprint Exercise: A Randomized, Double-Blind Cross-Over Study

Nutrients ◽

10.3390/nu10091222 ◽

2018 ◽

Vol 10 (9) ◽

pp. 1222 ◽

Cited By ~ 21

Author(s):

Eduardo Cuenca ◽

Pablo Jodra ◽

Alberto Pérez-López ◽

Liliana González-Rodríguez ◽

Sandro Fernandes da Silva ◽

...

Keyword(s):

Blood Lactate ◽

Wingate Test ◽

Beetroot Juice ◽

Double Blind ◽

Sprint Exercise ◽

Before And After ◽

S Cycling ◽

Improved Performance ◽

Lactate Levels ◽

Type Of Exercise

As a nitric oxide precursor, beetroot juice (BJ) is known to enhance high-intensity exercise performance (80–100% VO2max) yet its impacts on higher intensity sprint exercise (>100% VO2max) remain to be established. This study sought to examine the effects of BJ supplementation on performance and subsequent fatigue during an all-out sprint exercise. Using a randomized cross-over, double-blind, placebo-controlled design, 15 healthy resistance-trained men (22.4 ± 1.6 years) ingested 70 mL of either BJ or placebo. Three hours later, participants undertook a 30-s all-out Wingate test. Before and after the sprint exercise and at 30 s and 180 s post-exercise, three countermovement jumps (CMJ) were performed and blood lactate samples were obtained. Compared to placebo, BJ consumption improved peak (placebo vs. BJ, 848 ± 134 vs. 881 ± 135 W; p = 0.049) and mean (641 ± 91 vs. 666 ± 100 W; p = 0.023) power output and also reduced the time taken to reach Wpeak in the Wingate test (8.9 ± 1.4 vs. 7.3 ± 0.9 s; p = 0.003). No differences were detected in the fatigue index. In addition, while over time CMJ height and power diminished (ANOVA p < 0.001) and blood lactate levels increased (ANOVA p < 0.001), no supplementation effect was observed. Our findings indicate that while BJ supplementation improved performance at the 30-s cycling sprint, this improvement was not accompanied by differences in fatigue during or after this type of exercise.

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Hyperlactatemia Predicts Citrate Intolerance With Regional Citrate Anticoagulation During Continuous Renal Replacement Therapy

Journal of Intensive Care Medicine ◽

10.1177/0885066617701068 ◽

2017 ◽

Vol 34 (5) ◽

pp. 418-425 ◽

Cited By ~ 5

Author(s):

Jia-Neng Tan ◽

Sabrina Wong Peixin Haroon ◽

Amartya Mukhopadhyay ◽

Titus Lau ◽

Tanusya M. Murali ◽

...

Keyword(s):

Critically Ill ◽

Critically Ill Patients ◽

Characteristic Curve ◽

Kidney Injury ◽

Serum Lactate ◽

Organic Substrate ◽

Regional Citrate Anticoagulation ◽

Citrate Anticoagulation ◽

Peak Lactate ◽

Lactate Levels

Purpose: We aim to determine whether hyperlactatemia, which suggests multi-organ dysfunction and impaired organic substrate metabolism, may predict intolerance to regional citrate anticoagulation (RCA) during continuous venovenous hemofiltration (CVVH). Methods: We performed a single-center, retrospective observational study in critically ill patients with acute kidney injury or end-stage renal disease and evaluated the association of peak serum lactate levels with citrate intolerance (CI) during the initial 72 hours of RCA-CVVH, defined by serum total-to-ionized calcium >2.5 plus systemic hypocalcemia. Results: Eighty-eight patients were studied (aged 59 ± 14 years, 66% males, Acute Physiology and Chronic Health Evaluation II: 31 ± 8). Citrate was dosed at median 2.1 mmol/L of blood flow, with citrate load of 30 mmol/h, and CVVH effluent of 43 mL/kg/h. Twenty patients developed CI. Comparing patients with CI versus none, peak lactate levels were 8 (5-11) versus 3 (2-6) mmol/L, calcium replacement was 13 (10-17) versus 11 (8-12) mmol/h, and standard base excess was −4 (−12 to 1) versus 2(−4 to 7) mmol/L, respectively ( P < .05). Citrate intolerance developed in 38%, 44%, and 55%, in patients with peak lactate >4, >6, >7 mmol/L, respectively, versus 7% in those with peak lactate ≤4 mmol/L ( P ≤ .001), despite comparable citrate load and effluent rates across all categories. On multivariate analysis, hyperlactatemia and hyperbilirubinemia predicted CI ( P ≤ .01), which was associated with increasing calcium infusion requirement. Higher peak lactate from >4 to >7 mmol/L predicted CI with graded increase in odds ratio and specificity from 59% to 87%, but the corresponding negative predictive value from 93% to 87%. Area under nonparametric receiver operating characteristic curve for peak lactate and CI was 0.78. Conclusion: Hyperlactatemia predicts CI during RCA-CVVH with reasonable discriminatory performance in critically ill patients. Serum lactate surveillance may help preempt issues with citrate toxicity.

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Intraabdominal Hypertension in Patients with Septic Shock

The American Surgeon ◽

10.1177/000313480707300907 ◽

2007 ◽

Vol 73 (9) ◽

pp. 865-870 ◽

Cited By ~ 4

Author(s):

Tomas Regueira ◽

Pablo Hasbun ◽

Rolando Rebolledo ◽

Jose Galindo ◽

Marcia Aguirre ◽

...

Keyword(s):

Intensive Care Unit ◽

Septic Shock ◽

Intensive Care ◽

Surgical Intensive Care Unit ◽

Moderate Increase ◽

Tertiary Center ◽

Peak Lactate ◽

Intraabdominal Hypertension ◽

Lactate Levels ◽

High Lactate

Intraabdominal hypertension (IAH) develops frequently in patients with septic shock. Even a moderate increase in intraabdominal pressure (IAP) in this setting could be associated with high lactate levels. The authors conducted a prospective, observational, nonrandomized control trial in the surgical intensive care unit of an academic tertiary center. Twenty-seven patients with septic shock (septic shock group), and 19 patients undergoing abdominal surgery with more than two risk factors for IAH (postoperative control group) were admitted consecutively to the intensive care unit. IAP was measured every 6 hours during the first 48 hours. IAH was diagnosed with two consecutive measurements greater than 20 mm Hg. The main outcome measures were prevalence of IAH in septic shock and control groups; and comparative lactate levels, norepinephrine requirements and organ dysfunctions in patients with and without IAH in both groups. Fifty-one per cent of patients with septic shock and 31 per cent of control patients developed IAH. Patients with septic shock with and without IAH were comparable in peak norepinephrine dose, sequential organ failure assessment score, and mortality. However, peak lactate levels were significantly higher in patients with septic shock and IAH compared with those without IAH (3.5 mmol/L versus 1.9 mmol/L, P < 0.04). There was a significant positive temporal correlation between IAP and lactate levels in patients with septic shock with IAH. Peak levels of both occurred early and decreased progressively over time. Control patients with and without IAH exhibited comparable peak lactate levels. Intraabdominal hypertension is very common in septic shock and appears to be related to high lactate levels, which diminish as IAP decreases. Future studies should address the usefulness of IAP monitoring in patients with septic shock.

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Reliability of peak-lactate, heart rate, and plasma volume following the Wingate test

Medicine & Science in Sports & Exercise ◽

10.1097/00005768-199809000-00017 ◽

1998 ◽

Vol 30 (9) ◽

pp. 1456-1460 ◽

Cited By ~ 10

Author(s):

YITZHAK WEINSTEIN ◽

CEM BEDIZ ◽

RAFFY DOTAN ◽

BAREKET FALK

Keyword(s):

Heart Rate ◽

Plasma Volume ◽

Wingate Test ◽

Peak Lactate

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Analysis of sex-based differences in clinical and molecular responses to ischemia reperfusion after lung transplantation

Respiratory Research ◽

10.1186/s12931-021-01900-y ◽

2021 ◽

Vol 22 (1) ◽

Author(s):

Lourdes Chacon-Alberty ◽

Shengbin Ye ◽

Daoud Daoud ◽

William C. Frankel ◽

Hassan Virk ◽

...

Keyword(s):

Lung Transplantation ◽

Ischemia Reperfusion ◽

Molecular Response ◽

Proinflammatory Response ◽

Full Cohort ◽

Molecular Responses ◽

Peak Lactate ◽

The Difference ◽

Grade 3 ◽

Lactate Levels

Abstract Background Sex and hormones influence immune responses to ischemia reperfusion (IR) and could, therefore, cause sex-related differences in lung transplantation (LTx) outcomes. We compared men’s and women’s clinical and molecular responses to post-LTx IR. Methods In 203 LTx patients, we used the 2016 International Society for Heart and Lung Transplantation guidelines to score primary graft dysfunction (PGD). In a subgroup of 40 patients with blood samples collected before LTx (T0) and 6, 24, 48 (T48), and 72 h (T72) after lung reperfusion, molecular response to IR was examined through serial analysis of circulating cytokine expression. Results After adjustment, women had less grade 3 PGD than men at T48, but not at T72. PGD grade decreased from T0 to T72 more often in women than men. The evolution of PGD (the difference in mean PGD between T72 and T0) was greater in men. However, the evolution of IL-2, IL-7, IL-17a, and basic fibroblast growth factor levels was more often sustained throughout the 72 h in women. In the full cohort, we noted no sex differences in secondary clinical outcomes, but women had significantly lower peak lactate levels than men across the 72 h. Conclusions Men and women differ in the evolution of PGD and cytokine secretion after LTx: Women have a more sustained proinflammatory response than men despite a greater reduction in PGD over time. This interaction between cytokine and PGD responses warrants investigation. Additionally, there may be important sex-related differences that could be used to tailor treatment during or after transplantation.

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Value of Lactate Levels during ECMO Support for Refractory Cardiogenic Shock

The Thoracic and Cardiovascular Surgeon ◽

10.1055/s-0036-1571787 ◽

2016 ◽

Vol 64 (S 01) ◽

Author(s):

I. Slottosch ◽

O. Liakopoulos ◽

E. Kuhn ◽

A. Deppe ◽

M. Scherner ◽

...

Keyword(s):

Cardiogenic Shock ◽

Ecmo Support ◽

Refractory Cardiogenic Shock ◽

Lactate Levels

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Caffeine supplementation for 4-day, followed by acute ingestion, did not impact triathlete output power after submaximal intensity exercise

Revista Brasileira de Fisiologia do Exercício ◽

10.33233/rbfe.v18i3.3230 ◽

2019 ◽

Vol 18 (3) ◽

pp. 118

Author(s):

Anderson Pontes Morales ◽

Felipe Sampaio-Jorge ◽

Thiago Barth ◽

Alessandra Alegre De Matos ◽

Luiz Felipe Da Cruz Rangel ◽

...

Keyword(s):

Blood Lactate ◽

Output Power ◽

Body Mass ◽

Effect Size ◽

Power Output ◽

Anaerobic Power ◽

Lactate Concentration ◽

Wingate Test ◽

Large Effect Size ◽

Acute Ingestion

Introduction: The aim of this study was to test the hypothesis that caffeine supplementation (6 mg·kg-1 body mass) for 4-days, followed by acute intake, would impact five male triathletes output power after performed submaximal intensity exercise. Methods: This was a randomized, double-blind, placebo-controlled crossover study, placebo (4-day) - placebo (acute) PP, placebo (4-days) -caffeine (acute) PC, and caffeine (4-day) - caffeine (acute) CC. Participants abstained from dietary caffeine sources for 4 days and ingested capsules containing either placebo or caffeine (6 mg.kg-1 body mass day in one absorption). The acute trials the capsules containing placebo or caffeine (6 mg.kg-1 body mass day in one absorption) were ingested 60min before completing exercise in a treadmill for 40min (80% VO2max) and to perform the Wingate test. Results: Blood lactate was determined before, 60min after ingestion, and immediately after the exercise on the treadmill, the Wingate test, and after the recovery (10-min). CC and PC trials did not change the cardiopulmonary variables (P>0.05) and the anaerobic power variables (peak/mean power output and fatigue index) (P>0.05). The PC trial compared with PP promoted improvements in the curve power output in 2 sec by 31.19% (large effect-size d = 1.08; P<0.05) and 3 sec by 20% (large effect-size d = 1.19; P<0.05). A 10min recovery was not sufficient to reduce blood lactate concentration in the PC trial compared with PP (PC, 13.73±2.66 vs. PP, 10.26±1.60 mmol.L-1; P<0.05, respectively) (P<0.05). Conclusion: In conclusion, these results indicate that caffeine supplementation (6 mg·kg-1 body mass) for 4 days, followed by acute ingestion, did not impact the triathletes output power after performed submaximal intensity exercise. Nutritional interventions may help researchers and athletes to adapt strategies for manipulating caffeine use.Key-words: caffeine metabolism, Wingate test, blood lactate, performance.

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