scholarly journals Comparative study of physiological changes of nil per oral vs glucose water vs free water in patients undergoing laparoscopic cholecystectomy: A randomized prospective study

2021 ◽  
Vol 8 (2) ◽  
pp. 205-208
Author(s):  
Neelesh Anand ◽  
Shashi Prakash ◽  
Mandeep M H Madia ◽  
Braj Nandan Singh ◽  
Reetika Gupta
Keyword(s):  
Laparoscopic Cholecystectomy ◽  
Blood Glucose ◽  
Lactate Level ◽  
Serum Lactate ◽  
Hypoglycaemic Episode ◽  
Serum Lactate Level ◽  
Clear Water ◽  
Serum Electrolytes ◽  
Arterial Blood ◽  
Glucose Water

The aim of this study was to compare the effect of ingestion of clear water and glucose water over 10 hours NPO in elective laparoscopic cholecystetctomy surgery.An observational study was conducted in Sir Sunderlal hospital, Banaras Hindu University. The study included ASA I-II patients undergoing laparoscopic cholecystectomy surgery. Patients undergoing general anaesthesia were included in the study. Among three groups, the control fasted in accordance to nil per os for 10 hours, second and third group received 200 mL of clear water and 200 ml of glucose water, respectively 2 hours before the surgery. Arterial Blood Gas analysis and blood glucose level was done in the immediate post-operative period. Arterial pH, serum electrolytes, serum lactate and blood glucose levels were compared for the above 3 groups. Results were given as mean ± SD. Data collected were analysed using Student’s t-test. Differences were considered statistically significant if P values were <0.05. A total of 45 patients were included and 15 patients each were randomly assigned to one of the 3 groups. Patients who had 200 ml of clear water before surgery had lesser variation in serum K+ [p=0.045] and serum lactate level [p=0.001] than NPO. Patients fed with 200 ml of glucose water before surgery had lesser variation in serum K+ level [p=0.02], serum lactate level [p<0.001], in Random Blood Sugar level [p<0.001] and no episode of hypoglycaemia observed as compared to NPO. Patients given 200 ml of glucose water exhibited lesser variation in serum lactate level [p=0.004], in RBS level [p<0.001] and no hypoglycaemic episode recorded contrary to those supplied with 200 mL of clear water. More fluctuations in extreme values of pH and serum electrolytes values observed in group A. Episodes of hypoglycaemia found more frequent in NPO and patients that received only clear water. No significant side-effects were observed in any group.We conclude that it is safe to give clear drinks 2 hours prior to surgery. Prolonged withholding of oral fluid may cause imbalance in pH, serum electrolytes and hypoglycaemia. The finding confirms the recent ASA guidelines which no longer recommends an indiscriminate ‘NPO after midnight’ policy.

scholarly journals Postoperative hyperlactatemia and serum lactate level trends among heart transplant recipients

PeerJ ◽  
2020 ◽  
Vol 8 ◽  
pp. e8334
Author(s):  
Anna Kędziora ◽  
Karol Wierzbicki ◽  
Jacek Piątek ◽  
Hubert Hymczak ◽  
Izabela Górkiewicz-Kot ◽  
...  
Keyword(s):  
Heart Transplant ◽  
Lactate Level ◽  
Serum Lactate ◽  
Serum Lactate Level ◽  
Transplant Recipients ◽  
Arterial Blood ◽  
Subsequent Decrease ◽  
Heart Transplant Recipients ◽  
Lactate Levels ◽  
Peak Value

Background Advanced heart failure (HF), that affects 10% of the HF population, is associated with high mortality rate, meeting 50% at 1-year from diagnosis. For these individuals, heart transplantation (HTX) remains the ultimate and the gold-standard treatment option. Serum lactate level measurements has been proven useful for determining the outcome following other cardiac surgeries and among critically ill patients. Increased serum lactate levels are expected following HTX; however, no detailed analysis has been yet performed in this population. The research aims to estimate the prevalence of hyperlactatemia and describe early postoperative serum lactate level trends among heart transplant recipients. Materials and Methods Forty-six consecutive patients, who underwent HTX between 2010 and 2015, were enrolled into the retrospective analysis. Serum lactate level measurements within first 48 hours post-HTX were obtained every 6 hours from routinely conducted arterial blood gas analyses. The threshold for hyperlactatemia was considered at >1.6 mmol/L, according to upper limit of normal, based on internal laboratory standardization. The highest observed measurement within the observation, regardless of the time point of observation was determined for each patient individually and was appointed as Peak Value. Results Consecutively measured serum lactate levels differed in time (p = 0.000), with the initial increase and subsequent decrease of the values (4.3 vs. 1.9 mmol/l; p = 0.000). The increase from the baseline level to the Peak Value was statistically significant (4.3 vs. 7.0 mmol/l; p = 0.000). Various serum lactate level trends were identified, with one or more hyperlactatemia episodes. Eventually, 50% of the individuals had normal serum lactate levels at the end of the study, and hyperlactatemia was observed in the other half. Conclusions Throughout the observation, all of the patients experienced at least one episode of hyperlactatemia, with the median Peak Value of 7.0 (4.5–8.4) mmol/L. Various serum lactate level trends can be identified in post-HTX patients. Further research is required to determine the clinical usefulness of newly reported serum lactate level trends among heart transplant recipients.

Serum lactate level accurately predicts mortality in critically ill patients with cirrhosis with acute kidney injury

2018 ◽  
Vol 30 (11) ◽  
pp. 1361-1367 ◽  
Author(s):  
Dan-Qin Sun ◽  
Chen-Fei Zheng ◽  
Feng-Bin Lu ◽  
Sven Van Poucke ◽  
Xiao-Ming Chen ◽  
...  
Keyword(s):  
Acute Kidney Injury ◽  
Critically Ill ◽  
Critically Ill Patients ◽  
Lactate Level ◽  
Kidney Injury ◽  
Serum Lactate ◽  
Serum Lactate Level

scholarly journals Serum lactate level predicts 6-months mortality in hospitalized patients with decompensated cirrhosis

2019 ◽  
Author(s):  
Yue Zhang ◽  
Yuan Nie ◽  
Si-Zhe Wan ◽  
Cong Liu ◽  
Xuan Zhu
Keyword(s):  
Lactate Level ◽  
Multivariate Analyses ◽  
Predictive Accuracy ◽  
Roc Curves ◽  
Serum Lactate ◽  
Meld Score ◽  
Decompensated Cirrhosis ◽  
Serum Lactate Level ◽  
Initiation Of Therapy ◽  
Prediction Of Prognosis

Abstract Background The prediction of prognosis is an important part of management in decompensated cirrhosis (DeCi) patients with high long-term mortality. Lactate is a known predictor of outcome in critically ill patients. The aim of this study was to assess the prognostic value of lactate in DeCi patients.Methods We performed a single-center, observational, retrospective study of 456 DeCi patients extracted from hospitalization. Univariate and multivariate analyses were used to determine whether lactate was independently associated with the prognosis of DeCi patients. The AUROC was calculated to assess the predictive accuracy compared with existing scores.Results Serum lactate level was significantly higher in nonsurviving patients than in surviving patients. Univariate and multivariate analyses demonstrated that lactate was a risk-independent factor 6-months mortality (odds ratio: 1.412, P=0.001). ROC curves were drawn to evaluate the prediction efficiencies of lactate for 6-months mortality (AUROC: 0.716, P<0.001). Based on our patient cohort, the new scores (MELD+ lactate score, Child-Pugh+ lactate score) had good accuracy for predicting 6-months mortality (AUROC=0.769, P<0.001; AUROC= 0.766, P<0.001). Additionally, the performance of the new scores was superior to those of existing scores (all P < 0.001).Conclusion Serum lactate at admission may be useful for predicting 6-months mortality in DeCi patients, and the predictive value of the MELD score and Child-Pugh score were improved by adjusting lactate. Lactate should be part of the rapid diagnosis and initiation of therapy to improve clinical outcome.

Assessment of association of serum lactate level with retinopathy of prematurity

2021 ◽  
Vol 30 (1) ◽  
pp. 9
Author(s):  
Serdar OZATES ◽  
Emrah Utku KABATAS ◽  
Dilek DILLI ◽  
Aysegul ZENCIROGLU
Keyword(s):  
Retinopathy Of Prematurity ◽  
Lactate Level ◽  
Serum Lactate ◽  
Serum Lactate Level

scholarly journals Can the Preoperative Serum Lactate Level Predict the Extent of Bowel Ischemia in Patients Presenting to the Emergency Department with Acute Mesenteric Ischemia?

2017 ◽  
Vol 2017 ◽  
pp. 1-5 ◽  
Author(s):  
Peter C. Ambe ◽  
Kai Kang ◽  
Marios Papadakis ◽  
Hubert Zirngibl
Keyword(s):  
Lactate Level ◽  
Mesenteric Ischemia ◽  
Clinical Decision Making ◽  
Elevated Serum ◽  
Acute Mesenteric Ischemia ◽  
Serum Lactate ◽  
Bowel Ischemia ◽  
Serum Lactate Level ◽  
Ischemic Bowel ◽  
Preoperative Serum

Purpose. Early recognition of acute mesenteric ischemia (AMI) can be challenging. Extensive bowel necrosis secondary to AMI is associated with high rates of mortality. The aim of this study was to investigate the association between preoperative serum lactate level and the extent of bowel ischemia in patients with AMI. Methods. Data of patients with abdominal pain and elevated serum lactate undergoing emergency laparotomy for suspected AMI within 24 hours of presentation was retrospectively abstracted. The length of the ischemic bowel segment was compared with the preoperative serum lactate level. Results. 36 female and 39 male patients, with median age 73.1 ± 12.3 years, were included for analysis. The median preoperative lactate was 2.96 ± 2.59 mmol/l in patients with ≤50 cm, 6.86 ± 4.08 mmol/l in patients with 51–100 cm, 4.73 ± 2.76 mmol/l in patients with >100 cm ischemic bowel, and 14.07 ± 4.91 mmol/l in the group with multivisceral ischemia. Conclusion. Although elevated serum lactate might permit an early suspicion and thus influence the clinical decision-making with regard to prioritization of surgery in patients with suspected AMI, a linear relationship between serum lactate and the extent of bowel ischemia could not be established in this study.

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