scholarly journals Is there an association between body temperature and serum lactate levels in hip fracture patients?

2015 ◽  
Vol 97 (7) ◽  
pp. 513-518 ◽  
Author(s):  
F Murtuza ◽  
AJ Farrier ◽  
M Venkatesan ◽  
R Smith ◽  
A Khan ◽  
...  
Keyword(s):  
Hip Fracture ◽  
Body Temperature ◽  
Lactate Level ◽  
Aerobic Glycolysis ◽  
Anaerobic Respiration ◽  
Lactate Production ◽  
Serum Lactate ◽  
The Body ◽  
Significant Difference ◽  
Lactate Levels

Introduction Hyperlactataemia is associated with adverse outcomes in trauma cases. It is thought to be the result of anaerobic respiration during hypoperfusion. This produces much less energy than complete aerobic glycolysis. Low body temperature in the injured patient carries an equally poor prognosis. Significant amounts of energy are expended in maintaining euthermia. Consequently, there may be a link between lactate levels and dysthermia. Hyperlactataemia may be indicative of inefficient energy production and therefore insufficient energy to maintain euthermia. Alternatively, significant amounts of available oxygen may be sequestered in thermoregulation, resulting in anaerobic respiration and lactate production. Our study investigated whether there is an association between lactate levels and admission body temperature in hip fracture patients. Furthermore, it looked at whether there is a difference in the mean lactate levels between hip fracture patients with low (<36.5°C), normal (36.5–37.5°C) and high (>37.5°C) body temperature on admission, and for patients who have low body temperature, whether there is a progressive rise in serum lactate levels as body temperature falls. Methods The admission temperature and serum lactate of 1,162 patients presenting with hip fracture were recorded. Patients were divided into the euthermic (body temperature 36.5–37.5°C), the pyrexial (>37.5°C) and those with low body temperature (<36.5°C). Admission lactate and body temperature were compared. Results There was a significant difference in age between the three body temperature groups (p=0.007). The pyrexial cohort was younger than the low body temperature group (mean: 78 vs 82 years). Those with low body temperature had a higher mean lactate level than the euthermic (2.2mmol/l vs 2.0mmol/l, p=0.03). However, there was no progressive rise in serum lactate level as admission temperature fell. Conclusions The findings suggest that in hip fracture patients, the body attempts initially to maintain euthermia, incurring an oxygen debt. This would explain the difference in lactate level between the low body temperature and euthermic cohorts. The fact that there is no correlation with the degree of temperature depression and lactate levels indicates that the body does not fuel thermohomeostasis indefinitely with oxygen. Instead, in part, it abandons thermoregulatory mechanisms. Consequently, in this population, active rewarming may be indicated rather than depending on patients’ own thermogenic ability.

scholarly journals Laktátszintváltozások diabeteses ketoacidosisban és frissen diagnosztizált 1-es típusú diabetes mellitusban

2019 ◽  
Vol 160 (45) ◽  
pp. 1784-1790
Author(s):  
Kinga Jenei ◽  
Ildikó Szatmári ◽  
Eszter Szabó ◽  
Anjum Mariam ◽  
Andrea Luczay ◽  
...  
Keyword(s):  
Lactate Level ◽  
Lactate Concentration ◽  
Lactate Production ◽  
Serum Lactate ◽  
Total Serum ◽  
Serum Lactate Level ◽  
Newly Diagnosed ◽  
Lactate Levels ◽  
Diagnosed Diabetes ◽  
Newly Diagnosed Diabetes

Abstract: Introduction: It is known that lactate concentration is increased in diabetic ketoacidosis (DKA), however, the pathophysiology and kinetics of lactate changes are still unclear. Normally, L-lactate is the major form in the human body. According to previous data, also D- and L-lactate might be increased in hyperglycaemic disorders. Aim: We aimed to describe the kinetics and mechanisms of lactate concentration changes in ketoacidosis and newly diagnosed diabetes. Method: We performed a prospective study, including 5–18-year-old children with ketoacidosis (DKA, n = 13) and with newly diagnosed type 1 diabetes without ketoacidosis (T1DM, n = 6). We performed routine blood gas analysis 0–12–24–48 hours after admission, which also measured L-lactate levels. We also determined total venous serum lactate level by gas chromatography–mass spectrometry. Results: Initial plasma lactate concentration was increased in ketoacidosis as compared to the newly diagnosed diabetes group (p<0.05). After 12 h of rehydration, lactate levels were greatly reduced in ketoacidotic patients but after 24–48 h it was repeatedly increased (all p<0.01). In the 0–12 h phase, total serum lactate level was higher than L-lactate level, referring to D-lactate production. Conclusion: We described two L-lactate peaks in ketoacidosis. In the first 12 hours anaerobic glycolysis seems to have major role in hyperlactataemia. We assume that stimulated aerobic glycolysis leads to the second lactate peak. However, D-lactate is not routinely measured, it may contribute to the initial hyperlactataemia in both groups and is comparable to L-lactate production in ketoacidosis. Orv Hetil. 2019; 160(45): 1784–1790.

Elevated Serum Lactate Correlates With Intracranial Hemorrhage in Neonates Treated With Extracorporeal Life Support

PEDIATRICS ◽  
1995 ◽  
Vol 96 (5) ◽  
pp. 914-917
Author(s):  
Eva Nozik Grayck ◽  
Jon N. Meliones ◽  
Frank H. Kern ◽  
Doug R. Hansell ◽  
Ross M. Ungerleider ◽  
...  
Keyword(s):  
Intracranial Hemorrhage ◽  
Lactate Level ◽  
Life Support ◽  
Extracorporeal Life Support ◽  
Elevated Serum ◽  
Pediatric Intensive Care ◽  
Retrospective Chart Review ◽  
Serum Lactate ◽  
Platelet Counts ◽  
Lactate Levels

Objectives. To correlate the initial and maximal lactate levels with the occurrence of intracranial hemorrhage (ICH) and survival in patients treated with extracorporeal life support (ECLS). Design. Retrospective chart review. Setting. Pediatric intensive care unit. Patients. Eighty-two neonatal patients placed on ECLS for respiratory failure due to sepsis, meconium aspiration, or persistent pulmonary hypertension of the newborn. Measurements. The initial lactate level measured within 6 hours of initiating ECLS and the maximal lactate level measured throughout the ECLS course were collected. Lactate levels were described as mean lactate ± SE (mM). Head ultrasound reports and survival were reviewed. Platelet counts and activated clotting times (ACTs) were examined. Results. The mean initial and maximal lactate levels were higher in ECLS patients who developed ICH (initial: 10 ± 1.7 mM vs 6.4 ± 0.8 mM, p = .05 and maximal: 12.4 ± 2.5 mM vs 7.9 ± 0.8 mM, p = .04). Initial and maximal lactate levels were also elevated in nonsurvivors (initial: 11.7 ± 3 mM vs 6.4 ± 0.7 mM, p = .01 and maximal: 14.8 ± 3.3 mM vs 7.8 ± 0.8 mM, P &lt; .01). Platelet counts and ACT did not differ in patients with and without ICH. Conclusions. Lactate is a useful marker for the development of ICH in ECLS patients. In addition, elevated lactates during ECLS identify a subgroup of patients with poor outcome. Prospective studies are needed to determine whether the incorporation of this information into pre-ECLS and ECLS management will decrease the occurrence of ICH and improve survival.

Oxamate Enhances the Anti-Inflammatory and Insulin-Sensitizing Effects of Metformin in Diabetic Mice

Pharmacology ◽  
2017 ◽  
Vol 100 (5-6) ◽  
pp. 218-228 ◽  
Author(s):  
Mu-chao Wu ◽  
Wei-ran Ye ◽  
Yi-jia Zheng ◽  
Shan-shan Zhang
Keyword(s):  
Blood Lactate ◽  
Cell Mass ◽  
Lactate Production ◽  
Beta Cell Mass ◽  
Serum Lactate ◽  
Blood Levels ◽  
Anti Inflammatory ◽  
Lactate Levels ◽  
Blood Lactate Levels

Metformin (MET) is the first-line drug for treating type 2 diabetes mellitus (T2DM). However, MET increases blood lactate levels in patients with T2DM. Lactate possesses proinflammatory properties and causes insulin resistance (IR). Oxamate (OXA), a lactate dehydrogenase inhibitor, can decrease tissue lactate production and blood lactate levels. This study was conducted to examine the effects of the combination of OXA and MET on inflammation, and IR in diabetic db/db mice. Supplementation of OXA to MET led to lowered tissue lactate production and serum lactate levels compared to MET alone, accompanied with further decreased tissue and blood levels of pro-inflammatory cytokines, along with better insulin sensitivity, beta-cell mass, and glycemic control in diabetic db/db mice. These results show that OXA enhances the anti-inflammatory and insulin-sensitizing effects of MET through the inhibition of tissue lactate production in db/db mice.

Weak psoas and spine extensors potentially predispose to hip fracture

2020 ◽  
pp. 112070002090433
Author(s):  
Keong-Hwan Kim ◽  
Jun Hee Lee ◽  
Eic Ju Lim
Keyword(s):  
Hip Fracture ◽  
Lumbar Vertebra ◽  
Psoas Muscle ◽  
Hounsfield Unit ◽  
The Body ◽  
Whole Body ◽  
Cross Sectional ◽  
Fracture Group ◽  
Extensor Muscles ◽  
Significant Difference

Introduction: We performed a computed tomography analysis of muscle composition characteristics in hip fracture patients and non-hip fracture controls. Methods: In total, 43 patients (9 men, 34 women) were included in the hip fracture group, matched 1 to 1 with non-hip fracture controls. Muscle cross-sectional areas were measured in axial CT scan at the body level of the 4th lumbar vertebra (L4), intervertebral disc level between the 5th lumbar vertebra and the 1st sacral vertebra (L5-S1) and just below level of the lesser trochanter (LT). Attenuation was also evaluated through the mean Hounsfield unit (HU) in these areas. Results: The cross-sectional area per weight (CSA/Wt, mm2/kg) of psoas muscle and extensor muscles of the spine showed a significant difference between the 2 groups at both L4 (9.7 vs. 12.4, p  < 0.001 and 26.3 vs. 29.2, p  = 0.025) and L5-S1 (9.6 vs. 11.5, p  = 0.001 and 8.8 vs. 10.3, p  = 0.041) levels. In addition, the HU of these muscles differed significantly between the 2 groups at both L4 (33.3 vs. 47.6, p  < 0.001 and 13.7 vs. 30.2, p  < 0.001) and L5-S1 (39.7 vs. 52.6, p  < 0.001 and 3.8 vs. 15.1, p  = 0.012) levels. There was no difference in abdominal wall, gluteal, or thigh compartment musculature between the groups. Conclusions: Poorer quantity and quality of psoas muscle and extensor muscles of the spine rather than whole body muscles may contribute to falls and were characteristic features of the hip fracture patients in this series. These findings should be considered when recommending a preventive exercise and rehabilitation protocol.

scholarly journals Comparison of Tympanic and Tail Temperatures in Angus and Brahman Steers

2021 ◽  
Vol 5 (1) ◽  
Author(s):  
Dikmen S ◽  
Davila KMS ◽  
Rodriquez E ◽  
Scheffler TL ◽  
Oltenacu PA ◽  
...  
Keyword(s):  
Body Temperature ◽  
Repeated Measures ◽  
Core Body Temperature ◽  
The Body ◽  
Tympanic Temperature ◽  
Repeated Measure ◽  
Important Indicator ◽  
Significant Difference ◽  
Brahman Steers ◽  
Core Body

In cattle, core body temperature can be used as an important indicator of heat stress level. However, accurately recording core body temperature can be difficult and labor intensive. The objectives of the current study were 1) to compare the recorded tympanic and tail body temperature measurements in steers and 2) to determine the body temperature change of Angus and Brahman steers in a hot and humid environment. Data was analyzed using a repeated measure model where repeated measures were hourly tympanic and tail temperatures and their difference for individual steers during the day of the experiment. There was a significant breed effect (P=0.01), hour (P<0.0001) and breed by hour interaction (P<0.0001) for the tympanic temperature. Brahman steers, which are known to have superior thermotolerance, maintained a lower body temperature than the Angus steers during the afternoon under grazing conditions. In the Brahman steers there was only a minimal increase in the body temperature throughout the day, an evidence of the thermotolerance ability of the breed. In the Angus steers, which experienced an increase in their body temperature from hour to hour with a peak around 1600 hour; there was a significant difference between the tympanic and tail temperature during the times when the body temperature as measured by the tympanic recordings was the highest (1300 to 1700 hour). Our results indicate that the tympanic temperature can be used to accurately and continuously monitor core body temperature in a natural environment for up to several days and without disturbing the animal.

scholarly journals PRE AND POSTPRANDIAL THERMOGRAPHIC PROFILE OF GREEN IGUANAS (IGUANA IGUANA)

2016 ◽  
Vol 73 (2) ◽  
pp. 425
Author(s):  
Simona Rusu ◽  
Zdenek Knotek ◽  
Radu Lacatus ◽  
Ionel Papuc
Keyword(s):  
Heat Transfer ◽  
Body Temperature ◽  
Temperature Difference ◽  
The Body ◽  
Significant Difference ◽  
Before And After ◽  
Significant Temperature ◽  
Green Iguanas ◽  
The Right ◽  
Head Temperature

Abstract The body temperature of 10 clinically healthy green iguanas (Iguana iguana) was measured using a thermographic camera (FLIR E6, Flir Systems Sweden) before and after the food was offered. For each animal there were performed a total of 6 measurements (3 before feeding and 3 after the food was offered). The purpose of this experiment was to observe the thermographic pattern of the body before and after the feeding, since herbivore reptiles tend to bask after the feeding to increase the body temperature that will help them afterwards digest the food. The animals were housed in individual vivariums with every animal having a basking spot available. The pictures were taken outside the vivarium in an adjacent room. The animals were handled with gloves and transported in a cardboard box in order to avoid heat transfer between the handler and the iguana that would have produced thermal artefacts. Each individual was placed on a table on a styrofoam slate, again, to avoid the heat transfer between the table and the animal`s body. For each animal a total of 4 pictures were taken (up, front, left and right). The pictures were analysed with the FLIR Tools program that is provided by the manufacturer and 3 temperatures were taken into consideration (the head temperature, body temperature on the right side and body temperature on the left side). The temperatures were compared between them and with the temperature of the vivariums that consisted of the average between the temperature in 3 different spots (basking spot, the feeding bowl site and the coldest spot) measured with an infrared thermometer GM300 (Benetech, China). The temperature of the body was dependent on the vivarium temperature and it was a significant temperature difference between the measurements before the feeding and after the feeding. Also we discovered a significant difference between the head temperature and the body temperature on the left side before the feeding that disappeared after the animals ate. There was also a significant difference between the temperature on right side and on left side of the animals both before and after the feeding. No significant temperature difference was observed between the head and the right side of the body neither before nor after the feeding.

scholarly journals 262 Heat stress alleviation and dynamic temperature measurement for growing beef cattle

2020 ◽  
Vol 98 (Supplement_4) ◽  
pp. 192-193
Author(s):  
Sheyenne M Augenstein ◽  
Meredith A Harrison ◽  
Sarah C Klopatek ◽  
James W Oltjen
Keyword(s):  
Heat Stress ◽  
Body Temperature ◽  
Beef Cattle ◽  
Ambient Temperature ◽  
The Body ◽  
Control Group ◽  
Temperature Threshold ◽  
Sprinkler Systems ◽  
Significant Difference ◽  
The Impact

Abstract Heat stress continues to be a challenge for feedlot producers, forcing physiological adaptations in beef cattle that can have a negative impact on gain and carcass quality. Feedlots may want to incorporate systems that aid in mitigating heat stress, including sprinkler systems, which are commonly found on dairies. The objective of this study was to determine the impact of sprinkler systems on the body temperature of growing feedlot steers applied at three different temperature thresholds. Thirty-two Angus-cross beef steers (298 ± 15 SD days of age) were randomly assigned to 8 pens. Treatments were assigned to pens according to location to avoid drainage issues, with one replicate located on the eastern side of the feedlot and the other replicate located on the western side. Treatments including no sprinklers (C), high temperature threshold sprinklers (HT), moderate temperature threshold sprinklers (MT) or low temperature threshold sprinklers (LT). Sprinklers (flow rate: 5.11 L/min) were activated at 33°C (HT), 28°C (MT), and 23°C (LT) for five minutes at corresponding temperatures every thirty minutes for 57 days. Rectal temperature of steers in their pens was measured in the morning (0800 h), afternoon (1500 h), and evening (1900 h) three days each week (Monday, Wednesday, Friday) for a total of 19 experimental days. Weather measurements, including ambient temperature, windspeed, humidity and solar radiation were recorded at each measurement time along with the maximum values for each day. The change in body temperature (ΔBT) between the morning and afternoon was affected by ambient temperature (P &lt; 0.01); MT (P = 0.02) and LT (P = 0.02) – different than C. There was no significant difference between sprinkler treatments and the control group (P &gt; 0.05). Day affected (ΔBT) between the morning and afternoon (P &lt; 0.05) and the afternoon and evening (P &lt; 0.05). When averaged by day, the control group was significantly higher than MT (P = 0.04) between the morning and afternoon. The control group was also significantly higher than LT between the morning and afternoon (P = 0.03) and the afternoon and evening (P &lt; 0.01). The change in steer body temperature between afternoon and morning was affected by ambient temperature, and averaged across days, lowering the temperature threshold for sprinkling decreased in the afternoon and evening body temperature increase in steers.

scholarly journals Serum Lactate and Acute Mesenteric Ischemia: An Observational, Controlled Multicenter Study

2021 ◽  
Author(s):  
Olivier Collange ◽  
Marc LOPEZ ◽  
Anne LEJAY ◽  
Patrick PESSAUX ◽  
Alexandre OUATTARA ◽  
...  
Keyword(s):  
Multicenter Study ◽  
Mesenteric Ischemia ◽  
Acute Mesenteric Ischemia ◽  
Serum Lactate ◽  
Control Group ◽  
Adult Intensive Care Unit ◽  
Diagnosis And Prognosis ◽  
Significant Difference ◽  
Lactate Levels ◽  
Matching Criteria

Abstract Purpose Early diagnosis of acute mesenteric ischemia (AMI) is key to survival but remains extremely difficult, as the symptoms are vague and non-specific. Although international guidelines recommend that serum lactate is not used for AMI diagnosis, this parameter is still specifically taken into account for the diagnosis and prognosis of AMI. Our hypothesis was that serum lactate levels cannot be used to diagnose AMI or predict its outcome. Methods This was an ancillary, retrospective, observational, controlled multicenter study, approved by an Ethics Committee. Patients with AMI at adult intensive care unit (ICU) admission were included (AMI group) and matched to ICU patients without AMI (control group). Matching criteria were center, period, gender, age, and severity. Serum lactate levels were measured on day 0 (D0) and day 1 (D1) and the lactate difference (D0-D1) was calculated. Results Two hundred and seventy-four patients were included. Serum lactate levels were elevated in both groups at D0 and D1 but there was no significant difference between groups at D0 (2.7 [1.3; 5.5] vs 3.4 [1.9; 6.1] mmol/L; p = 0.284), D1 (1.8 [1.2; 3.1] vs 2.4 [1.5; 4.6] mmol/L, p = 0.547; respectively for control and AMI groups) or D0-D1. Thus, the performance of serum lactate for AMI diagnosis was poor. Concerning AMI outcome, serum lactate levels predicted ICU death in both groups at D0 and D1. Conclusions no specific association was observed between serum lactate levels and AMI. Serum lactate should not be used for the diagnosis of AMI but may help assess disease severity.

scholarly journals An analytical observational study on the prognostic implication of postoperative serial serum lactate level for complications and predicting length of intensive therapy unit stay after major abdominal surgery

2021 ◽  
Vol 9 (5) ◽  
pp. 1428
Author(s):  
Moumita Mondal ◽  
Sankari Santra ◽  
Rajat Choudhuri ◽  
Amartya Das
Keyword(s):  
Respiratory Failure ◽  
Postoperative Complications ◽  
Abdominal Surgery ◽  
Intensive Therapy ◽  
Wound Dehiscence ◽  
Serum Lactate ◽  
Serum Lactate Level ◽  
Intensive Therapy Unit ◽  
Significant Difference ◽  
Lactate Levels

Background: Post-operative microcirculatory alteration causes hypoperfusion, tissue hypoxia and organ dysfunction, resulting in significant morbidity and mortality. Increase in serum lactate level in response to tissue hypoxia may serve as a cost effective tool to assess status of all organ dysfunction being sensitive but not organ specific and may help in early prognostication. Aim of this study was to investigate the association of blood lactate levels during the first 24 hours after surgery with postoperative morbidity and mortality, with length of ITU stay and to correlate the lactate values at various time points with different postoperative complications (POC).Methods: 150 patients undergoing elective abdominal surgery were included. Blood lactate (mmol/lit) levels were measured immediately on admission to the Intensive Therapy Unit (ITU) and at 6, 12, and 24 hours of admission. The parameters of clinical outcome included were mortality, shock, Acute kidney injury (AKI), respiratory failure, wound dehiscence and length of ITU stay. Heart Rate, Mean Arterial Pressure, spo2, Temperature and Urine output were also measured.Results: There was statistically significant difference in the lactate levels measured at the above mentioned point of time (0, 6, 12 and 24h) in cases with death and without fatal outcome, with and without respiratory failure, with and without AKI, with and without shock and in cases with and without wound dehiscence (p<0.05). There was a statistically significant difference in urine output, duration of ITU stay and duration of intubation (p<0.05).Conclusions: Increased serum lactate levels were significantly associated with postoperative complications, mortality and length of ITU stay in patients undergoing major elective abdominal surgery.

scholarly journals Relative Hyperlactatemia in the Emergency Department: A Retrospective Cohort Study

2020 ◽  
Author(s):  
Ralphe Bou Chebl ◽  
Sarah Jamali ◽  
Nancy Mikati ◽  
Reem Al Assaad ◽  
Karim Abdel Daem ◽  
...  
Keyword(s):  
Emergency Department ◽  
Hospital Mortality ◽  
Lactate Level ◽  
Reference Range ◽  
Serum Lactate ◽  
Optimal Cutoff ◽  
The Mean ◽  
Emergency Department Patients ◽  
Lactate Levels ◽  
Youden’S Index

Abstract Objective The clinical interpretation of lactate ≤ 2.00 mmol/L in emergency department (ED) patients is not well characterized. This study aims to determine the optimal cutoff value for lactate within the reference range that predicts in-hospital mortality among ED patients with initial serum lactate levels within the reference range. Methods This was a retrospective study of adult patients presenting to a tertiary ED between the dates of January 1, 2014 and June 30, 2019 with an initial serum lactate level less than 2.00 mmol/L. The primary outcome was in-hospital mortality. Youden’s index was utilized to determine the optimal threshold that predicts mortality. Patients above the threshold were labeled as having relative hyperlactatemia. A multivariate logistic regression was performed to determine the association between relative hyperlactatemia and in-hospital mortality. Subgroup analyses were done to further examine the interaction between relative hyperlactatemia and hospital mortality. Results During the study period, 1638 patients were included. The mean age was 66.9 ± 18.6 years, 47.1% of the population were female, and the most prevalent comorbidity was hypertension (56.7%). The mean lactate level at presentation was 1.5 ± 0.3 mmol/L. In-hospital mortality was 3.8% in the overall population and 16.2% were admitted to the ICU. A lactate of 1.33 mmol/L was found to be the optimal cutoff that best discriminates between survivors and non-survivors. Relative hyperlactatemia was an independent predictor of in-hospital mortality (OR 1.78 CI1.18-4.03; p 0.02). Finally, Relative hyperlactatemia was associated with increased mortality in patients without hypertension (4.7% versus 1.1%; p 0.008), as well as patients without diabetes or COPD. Conclusion The optimal cutoff of initial serum lactate that discriminates between survivors and non-survivors is in the ED 1.33 mmol/L. Relative hyperlactatemia is associated with increased mortality in emergency department patients, and this interaction seems to be more important in healthy patients.

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