scholarly journals Sequential blood lactate measurement as a predictor of mortality in patients with sepsis in the critical care unit

2021 ◽  
Author(s):  
Pollov Borah ◽  
Dilip Kumar Saloi ◽  
Bipul Deka ◽  
Ranjumoni Konwar ◽  
Deepjyoti Kalita ◽  
...  
Keyword(s):  
Critical Care ◽  
Severe Sepsis ◽  
Blood Lactate ◽  
Critical Care Unit ◽  
Clinical Status ◽  
Tertiary Care ◽  
P Value ◽  
The Mean ◽  
Lactate Levels ◽  
Blood Lactate Levels

Abstract Background and objectiveIn severe sepsis, increased blood lactate levels are observed indicating impaired oxidative phosphorylation, which secondarily causes hypoxic hypoxia and stagnant tissue hypoxia. Among all other related factors, a high rise of the lactate level in blood may be a useful predictor of sepsis patients' mortality. This study aims to determine the association of consecutive blood lactate levels with the patient's mortality with sepsis admitted in the Critical Care Unit (CCU). MethodsThis prospective study included 50 patient of septicemia at CCU above 18 years in a tertiary care centre. On admission, at 24 hours and 72 hours, blood lactate levels were monitored. Their clinical status was evaluated for 28 days to categorise as survivor and non-survivor. The statistical analysis was made with Microsoft Excel and SPSS version 20. To test the difference in mean blood lactate levels among survivors and non-survivors Student’s t-test was applied. A p-value of less than 0.05 was considered significant. Prior ethical clearance from the institutional ethics committee of human with informed consent from the patients was obtained for data collection.ResultsThe current study included 50 patients of septicemia, 23 were survivors, and 27 were non-survivors after 28 days of follow up. The mean lactate range for the 23 survivors was ranged from 0.43 mmol/l to 5.69 mmol/l, whereas for non-survivors, it was 1.64 mmol/l to 6.14 mmol/l. The mean value of lactate for the survivors and non-survivors during admission, at 24 hours and at 72 hours were 0.9545±0.45798 vs 2.5204±1.51498, 1.2461±1.21360 vs 2.5107±1.63678 and 1.5496±1.66788 vs 2.7904±2.00160. The differences between the mean lactate values between survivors and non-survivors at different time intervals were highly significant.ConclusionA slower rate of lactate clearance during hospitalisation may be a significant factor associated with severe sepsis patient mortality. Thus serial blood lactate levels is a significant predictor of mortality and should be monitored.

COMBINATION OF BLOOD LACTATE LEVELS AND pHi IN SEVERE SEPSIS

1994 ◽  
Vol 22 (1) ◽  
pp. A113
Author(s):  
Gilberto Friedman ◽  
Giorgio Berlot ◽  
Robert J. Kahn ◽  
Jean-Louis Vincent
Keyword(s):  
Severe Sepsis ◽  
Blood Lactate ◽  
Lactate Levels ◽  
Blood Lactate Levels

scholarly journals Alteration of Blood Lactate Levels in Severe Falciparum Malaria: A Systematic Review and Meta-Analysis

Biology ◽  
2021 ◽  
Vol 10 (11) ◽  
pp. 1085
Author(s):  
Polrat Wilairatana ◽  
Wanida Mala ◽  
Manas Kotepui ◽  
Kwuntida Uthaisar Kotepui
Keyword(s):  
Severe Malaria ◽  
Blood Lactate ◽  
Lactate Level ◽  
Uncomplicated Malaria ◽  
Weighted Mean Difference ◽  
Blood Lactate Level ◽  
Mean Difference ◽  
The Mean ◽  
Lactate Levels ◽  
Blood Lactate Levels

Metabolic acidosis in severe malaria usually occurs in the form of lactic acidosis. The present study aimed to collate articles from the literature that have reported blood lactate levels in patients with severe malaria and tested the hypothesis that blood lactate levels are elevated in patients with malaria compared to those with uncomplicated malaria. Moreover, the difference in lactate levels between patients who died and those who survived was estimated using a meta-analytic approach. Potentially relevant studies were searched for in PubMed, Web of Science, and Scopus. The quality of the included studies was assessed using the Jadad scale and strengthening the reporting of observational studies in epidemiology (STROBE). The pooled mean blood lactate in patients with severe malaria, the pooled weighted mean difference (WMD) of blood lactate between patients with severe malaria and those with uncomplicated malaria, and the pooled WMD and 95% CI of blood lactate between patients who died from and those who survived severe malaria were estimated using the random-effects model. Heterogeneity among the outcomes of the included studies was assessed using Cochran’s Q and I2 statistics. A meta-regression analysis was performed to identify the source(s) of heterogeneity of outcomes among the included studies. A subgroup analysis was further performed to separately analyze the outcomes stratified by the probable source(s) of heterogeneity. Publication bias was assessed by the visual inspection of the funnel plot asymmetry. Of 793 studies retrieved from the searches, 30 studies were included in qualitative and quantitative syntheses. The pooled mean lactate in patients with severe malaria was 5.04 mM (95% CI: 4.44–5.64; I2: 99.9%; n = 30,202 cases from 30 studies). The mean lactate in patients with severe malaria (1568 cases) was higher than in those with uncomplicated malaria (1693 cases) (p = 0.003; MD: 2.46; 95% CI: 0.85–4.07; I2: 100%; nine studies). The mean lactate in patients with severe malaria who died (272 cases) was higher than in those with severe malaria who survived (1370 cases) (p < 0.001; MD: 2.74; 95% CI: 1.74–3.75; I2: 95.8%; six studies). In conclusion, the present study showed a high mean difference in blood lactate level between patients with severe malaria and patients with uncomplicated malaria. In addition, there was a high mean difference in blood lactate level between patients with severe malaria who died compared to those with severe malaria who survived. Further studies are needed to investigate the prognostic value of blood lactate levels to identify patients who are at high risk of developing severe malaria or dying.

scholarly journals The Effect of Vitamin E Supplementation on Muscular Fatigue in Professional Men's Athletics

2019 ◽  
Vol 55 (3) ◽  
pp. 171
Author(s):  
Yusni Yusni ◽  
Amiruddin Amiruddin
Keyword(s):  
Vitamin E ◽  
Muscle Fatigue ◽  
Blood Lactate ◽  
P Value ◽  
Homogeneity Test ◽  
Significant Difference ◽  
Men's Athletics ◽  
Lactate Levels ◽  
Blood Lactate Levels ◽  
Vitamin E Supplementation

High-intensity exercise (3000-meter runner) contributes to muscle fatigue. Fatigue can be determined by measuring blood lactate levels. Blood lactate levels are a product of anaerobic metabolism. Lactate accumulation due to anaerobic physical activity can inhibit the glycolytic enzyme that affects decreased ATP production, damage of the calcium and sodium pumps in the muscles and causes fatigue. This study aimed to analyze the effect of vitamin E on the level of fatigue through the response of blood lactate levels in the runner 3000 meters. This research was a quasi-experimental research with a pretest-posttest design. Research subjects were 9 volunteer athletes (3000 meters runners) Aceh province, male, and aged 15-20 years. The treatments were vitamin E at a dose of 1x400 IU per day and administered for 14 days. Blood lactate levels were examined using the method of calorimetry. The statistical analysis was using the homogeneity test of variance (Levene's test), the normality test (Kolmogorov-Smirnov test) and paired t-test with a significant level of 5% (p-value<0.05). The results showed that blood lactate levels decreased approximately 13.93% after vitamin E supplementation. There was no significant difference (p=0.27) between blood lactate levels before and after vitamin E supplementation in athletes. In conclusion, vitamin E supplementation did not significantly lower blood lactate levels therefore vitamin E did not significantly reduce muscle fatigue in men's athletics.

scholarly journals Effects of whole-body neuromuscular electrical stimulation device on hemodynamics, arrhythmia, and sublingual microcirculation

2021 ◽  
Author(s):  
Megumi Hoshiai ◽  
Kaori Ochiai ◽  
Yuma Tamura ◽  
Tomoki Tsurumi ◽  
Masato Terashima ◽  
...  
Keyword(s):  
Electrical Stimulation ◽  
Blood Glucose ◽  
Blood Lactate ◽  
Neuromuscular Electrical Stimulation ◽  
Whole Body ◽  
Left Ventricular Ejection ◽  
Sublingual Microcirculation ◽  
Blood Fluidity ◽  
Lactate Levels ◽  
Blood Lactate Levels

AbstractNeuromuscular electrical stimulation has been used to treat cardiovascular diseases and other types of muscular dysfunction. A novel whole-body neuromuscular electrical stimulation (WB-NMES) wearable device may be beneficial when combined with voluntary exercises. This study aimed to investigate the safety and effects of the WB-NMES on hemodynamics, arrhythmia, and sublingual microcirculation. The study included 19 healthy Japanese volunteers, aged 22–33 years, who were not using any medication. Electrocardiogram (ECG), echocardiography, and blood sampling were conducted before a 20-min WB-NMES session and at 0 and 10 min after termination of WB-NMES. Their tolerable maximum intensity was recorded using numeric rating scale. Arrhythmia was not detected during neuromuscular electrical stimulation or during 10 min of recovery. Blood pressure, heart rate, left ventricular ejection fraction, and diastolic function remained unchanged; however, mild mitral regurgitation was transiently observed during WB-NMES in a single male participant. A decrease in blood glucose and an increase in blood lactate levels were observed, but no changes in blood fluidity, sublingual microcirculation, blood levels of noradrenaline, or oxidative stress were shown. WB-NMES is safe and effective for decreasing blood glucose and increasing blood lactate levels without changing the blood fluidity or microcirculation in healthy people.

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.

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.

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