scholarly journals Serial blood lactate levels as a prognostic factor for sepsis mortality

2014 ◽  
Vol 54 (3) ◽  
pp. 168
Author(s):  
Keswari Aji Patriawati ◽  
Nurnaningsih Nurnaningsih ◽  
Purnomo Suryantoro
Keyword(s):  
Blood Lactate ◽  
Lactate Clearance ◽  
Major Health Problem ◽  
Major Health ◽  
Serial Blood ◽  
Factors Associated ◽  
Relative Risks ◽  
Increased Risk ◽  
Lactate Levels ◽  
Blood Lactate Levels

Background Sepsis is a major health problem in children and aleading cause of death. In recent decades, lactate has been studiedas a biomarker for sepsis, and as an indicator of global tissuehypoxia, increased glycolysis, endotoxin effect, and anaerobicmetabolism. Many studies h ave shown both high levels andincreased serial blood lactate level measurements to be associatedwith increased risk of sepsis mortality.Objective To evaluate serial blood lactate levels as a prognosticfactor for sepsis mortality.Methods We performed an observational, prospective study in thePediatric Intensive Care Unit (PICU) at DR. Sardjito Hospital,Yogyakarta from July to November 2012. We collected serialblood lactate specimens of children with sepsis, first at the time ofadmission, followed by 6 and 24 hours later. The outcome measurewas mortality at the end ofintensive care. Relative risks and 95%confidence intervals of the factors associated with mortality werecalculated using univariate and multivariate analyses.Results Sepsis was found in 91 (50.3%) patients admitted tothe PIW , of whom 75 were included in this study. Five patients(6. 7%) died before the 24-hour lactate collection and 39 patients(52.0%) died during the study. Blood lactate levels of ~ 4mmol;Lat the first and 24-hour specimens were associated with mortality(RR 2.9; 95%CI 1.09 to 7 .66 and RR 4.92; 95%CI 1.77 to 13.65,respectively). Lactate clearance of less than 10% at 24 hours(adjusted RR 5.3; 95% CI 1.1 to 24.5) had a significantly greaterrisk fo llowed by septic shock (adjusted RR 1.54; 95%CI 1.36 to6.4 7) due to mortality.Conclusion In children with sepsis there is a greater risk of mortalityin those with increasing or persistently high serial blood lactatelevels, as shown by less than 10% lactate clearance at 24-hours afterPIW admission.

Serial blood lactate levels as a predictor of mortality in children after cardiopulmonary bypass surgery

2008 ◽  
Vol 9 (3) ◽  
pp. 285-288 ◽  
Author(s):  
Meena Kalyanaraman ◽  
William M. DeCampli ◽  
Andrew I. Campbell ◽  
Utpal Bhalala ◽  
Terry G. Harmon ◽  
...  
Keyword(s):  
Cardiopulmonary Bypass ◽  
Blood Lactate ◽  
Bypass Surgery ◽  
Serial Blood ◽  
Cardiopulmonary Bypass Surgery ◽  
Lactate Levels ◽  
Blood Lactate Levels

scholarly journals Serial blood lactate levels as a prognostic factor for sepsis mortality

2014 ◽  
Vol 54 (3) ◽  
pp. 168-173
Author(s):  
Keswari Aji Patriawati ◽  
Nurnaningsih Nurnaningsih ◽  
Purnomo Suryantoro
Keyword(s):  
Prognostic Factor ◽  
Blood Lactate ◽  
Sepsis Mortality ◽  
Serial Blood ◽  
Lactate Levels ◽  
Blood Lactate Levels

Serial blood lactate levels can predict the development of multiple organ failure following septic shock

1996 ◽  
Vol 171 (2) ◽  
pp. 221-226 ◽  
Author(s):  
Jan Bakker ◽  
Philippe Gris ◽  
Michel Coffernils ◽  
Robert J. Kahn ◽  
Jean-Louis Vincent
Keyword(s):  
Septic Shock ◽  
Multiple Organ Failure ◽  
Organ Failure ◽  
Blood Lactate ◽  
Multiple Organ ◽  
Serial Blood ◽  
Lactate Levels ◽  
Blood Lactate Levels

scholarly journals Prognostic Significance of Blood Lactate and Lactate Clearance in Trauma Patients

2012 ◽  
Vol 117 (6) ◽  
pp. 1276-1288 ◽  
Author(s):  
Marie-Alix Régnier ◽  
Mathieu Raux ◽  
Yannick Le Manach ◽  
Yves Asencio ◽  
Johann Gaillard ◽  
...  
Keyword(s):  
Blood Lactate ◽  
Injury Severity ◽  
Prognostic Significance ◽  
Lactate Clearance ◽  
Trauma Patients ◽  
Operating Characteristics ◽  
Additional Information ◽  
Lactate Levels ◽  
Initial Blood ◽  
Blood Lactate Levels

Background Lactate has been shown to be a prognostic biomarker in trauma. Although lactate clearance has already been proposed as an intermediate endpoint in randomized trials, its precise role in trauma patients remains to be determined. Methods Blood lactate levels and lactate clearance (LC) were calculated at admission and 2 and 4 h later in trauma patients. The association of initial blood lactate level and lactate clearance with mortality was tested using receiver-operating characteristics curve, logistic regression using triage scores, Trauma Related Injury Severity Score as a reference standard, and reclassification method. Results The authors evaluated 586 trauma patients (mean age 38±16 yr, 84% blunt and 16% penetrating, mortality 13%). Blood lactate levels at admission were elevated in 327 (56%) patients. The lactate clearance should be calculated within the first 2 h after admission as LC0-2 h was correlated with LC0-4 h (R=0.55, P<0.001) but not with LC2-4 h (R=0.04, not significant). The lactate clearance provides additional predictive information to initial blood lactate levels and triage scores and the reference score. This additional information may be summarized using a categorical approach (i.e., less than or equal to -20 %/h) in contrast to initial blood lactate. The results were comparable in patients with high (5 mM/l or more) initial blood lactate. Conclusions Early (0-2 h) lactate clearance is an important and independent prognostic variable that should probably be incorporated in future decision schemes for the resuscitation of trauma patients.

Correlation of serial blood lactate levels to organ failure and mortality after trauma

1995 ◽  
Vol 13 (6) ◽  
pp. 619-622 ◽  
Author(s):  
Panagiotis Manikis ◽  
Stanislaw Jankowski ◽  
Haibo Zhang ◽  
Robert J Kahn ◽  
Jean-Louis Vincent
Keyword(s):  
Organ Failure ◽  
Blood Lactate ◽  
Serial Blood ◽  
Lactate Levels ◽  
Blood Lactate Levels

scholarly journals In vivo lactate kinetics at rest and during recovery from exhaustive exercise in coho salmon (Oncorhynchus kisutch) and starry flounder (Platichthys stellatus)

1988 ◽  
Vol 135 (1) ◽  
pp. 119-131 ◽  
Author(s):  
C. L. Milligan ◽  
D. G. McDonald
Keyword(s):  
Blood Lactate ◽  
Turnover Rate ◽  
Coho Salmon ◽  
Oncorhynchus Kisutch ◽  
Lactate Clearance ◽  
Turnover Rates ◽  
Platichthys Stellatus ◽  
Lactate Turnover ◽  
Lactate Levels ◽  
Blood Lactate Levels

A bolus injection of [14C]lactate was used to measure lactate turnover rates at rest and during recovery from exhaustive exercise in coho salmon (Oncorhynchus kisutch) and starry flounder (Platichthys stellatus). At rest, lactate turnover rate in salmon was almost double that in flounder (1.33 versus 0.76 mumol min-1 kg-1), which reflected the higher blood lactate level in salmon (1.00 versus 0.12 mmol l-1). From 2 to 4 h after exercise, when blood lactate levels were at their peak and constant, turnover rates were elevated in both species, though to a greater extent in salmon than in flounder (11.88 versus 2.27 mumol min-1 kg-1). Lactate concentration and turnover rate were linearly correlated in both species. The higher turnover rate in salmon was solely a consequence of the higher blood lactate levels since, at similar blood lactate concentrations, turnover rates in flounder and salmon were the same. Therefore, the lower blood lactate levels in flounder after exercise were not a consequence of higher turnover. In neither species was the turnover rate adequate to account for the rate of lactate clearance from the muscle, suggesting a large portion was retained within the muscle and metabolized in situ. Furthermore, following injection of [14C]lactate, greater than 80% of the total blood activity was recovered as lactate, indicating that little label was incorporated into other products (e.g. glucose). These data suggest that the Cori cycle plays a minimal role in the metabolism of lactate in salmon and flounder. Furthermore, at least in flounder, there was no correlation between the kinetics of lactate clearance and O2 consumption, suggesting that the classical concept of ‘O2 debt’ is not applicable in this species.

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