scholarly journals Serum Lactate/Albumin Ratio as a Predictor Of Morbidity and Mortality In Patients with Severe Sepsis and Septic Shock

2020 ◽  
Vol 0 (0) ◽  
pp. 0-0
Author(s):  
Essam Makram ◽  
Mohamed Ibrahim ◽  
Ahmed Abdel Rahman ◽  
Karim aboraya
2017 ◽  
Vol 2 (2) ◽  
pp. 191-195 ◽  
Author(s):  
Sameer Thapa ◽  
PN Prasad ◽  
YM Shakya

IntroductionSevere sepsis and septic shock, is a common cause of emergency room admission and is associated with high morbidity and mortality worldwide. This study inspects the prediction of mortality in severe sepsis and septic shock with increased lactate/albumin ratio.Objective The objective of the study was to predict the serum lactate albumin ratio as an indicator of mortality in severe sepsis and septic shock.MethodologyIt was a hospital based cross sectional study done at Tribhuvan University Teaching Hospital, Kathmandu from November 2015 to October 2016. The consent was taken from patients. Acute Physiology and Chronic Health Evaluation II score, serum lactate and serum albumin levels on first day of arrival in emergency room were calculated. Patients were classified as severe sepsis and septic shock and treated according to Surviving Sepsis Campaign 2012 guideline. The patient were follow up at 28 day, The associations of 28-day outcome with Acute Physiology and Chronic Health Evaluation II score, serum lactate value, serum albumin value and serum lactate albumin ratio value were derived.ResultsOut of total 240 severe sepsis and septic shock patients it is found that increased serum lactate/albumin ratio was an independent predictor of the mortality with cut off value of 0.07. Furthermore serum lactate albumin ratio shows strong correlation with APACHE 2 score in predicting mortality in severe sepsis and septic shock.ConclusionIncreased lactate/albumin ratio predicts mortality in patients with severe sepsis and septic shock.  Birat Journal of Health Sciences  Vol.2/No.1/Issue 2/ Jan - April 2017, Page: 191-195


2021 ◽  
Vol 8 (1) ◽  
pp. 34-38
Author(s):  
Subroto Kumar Sarker ◽  
Umme Kulsum Choudhury ◽  
Mohammad Mohsin ◽  
Subrata Kumar Mondal ◽  
Muslema Begum

Background: Detection of anaerobic metabolism is very crucial for the management of the septic patients. Objective: The purpose of the present study was to validate the ratio between differences of central venous to arterial CO2 and arterial to central venous O2 content in diagnosis of anaerobic metabolism among septic patients. Methodology: This prospective observational study was conducted in the Intensive Care Unit of the department of Anaesthesia Analgesia, Palliative and Intensive Care Medicine at Dhaka Medical College Hospital, Dhaka, Bangladesh from January 2016 to December 2016. All patients admitted to ICU with the features of severe sepsis and septic shock according to SSC guidelines with the age of more than or equal to 18 years in both sexes were included in this study. The arterial and central venous blood gases were measure simultaneously. At the same time serum lactate was measured. Result: Among the 69 patients, 31(44.9%) were of severe sepsis and 38(55%) were of septic shock patients. In the severe sepsis and septic shock patients the mean P(v-a)CO2/C(a-v)O2 is 1.39±0.41 and 1.11±0.40 respectively. Serum lactate in case of severe sepsis and septic shock patients is 2.85±1.40 and 3.85±1.04 respectively. The ROC analysis showed an area under curve 0.89 and P(v-a)CO2/C(a-v)O2 ratio cutoff value of 1.21 showed sensitivity 0.84 and specificity 0.94. Conclusion: The P(v-a)CO2/C(a-v)O2  ratio is also a another marker of global anaerobic metabolism and it would be used for diagnosis as well as management of septic patient.  Journal of Current and Advance Medical Research, January 2021;8(1):34-38


Clinics ◽  
2006 ◽  
Vol 61 (1) ◽  
pp. 47-52 ◽  
Author(s):  
Marcelo Park ◽  
Luciano Cesar Pontes Azevedo ◽  
Alexandre Toledo Maciel ◽  
Vladimir Ribeiro Pizzo ◽  
Danilo Teixeira Noritomi ◽  
...  

2021 ◽  
pp. 8-10
Author(s):  
Anisha Tanwar ◽  
Bushra Fiza ◽  
Bhupesh Medatwal ◽  
Rubal Singh ◽  
Maheep Sinha

INTRODUCTION:- Sepsis is a leading cause of morbidity and mortality internationally Early spotting and . interventions are essential to ensure better patient's outcome. Lactate concentration in septic patients is of particular prognostic value in predicting septic shock and mortality. AIM:- The present study was intended to evaluate the serum Lactate levels on the basis of severity rate in patients suffering of sepsis, severe sepsis and septic shock. MATERIAL & METHOD:- 100 patients diagnosed for sepsis were enrolled for the study and they were grouped as sepsis (n=30), severe sepsis (n=37)and septic shock (n=33). On the basis of survival rate serum Lactate levels in patients with sepsis were estimated in all the 3 categories of subjects according to the inclusion criteria. A p-Value of ≤0.05 were considered as statistically significant. RESULT:- In the present study when the lactate levels were evaluated among all the three categories, it was observed that the Lactate levels were found to be statistically significant (p-value <0.0001). Lactic acid evaluated on the basis of survival rate was also found to be statistically significant with the p-Value 0.015. CONCLUSION:- Lactic acid could be utilized as a reliable marker to assess prognosis at the initial phase of presentation because its initial evaluation shows good predictability in mortality prediction in sepsis patients.


2015 ◽  
Vol 30 (2) ◽  
pp. 271-275 ◽  
Author(s):  
Biao Wang ◽  
Gang Chen ◽  
Yifei Cao ◽  
Jiping Xue ◽  
Jia Li ◽  
...  

BMJ Open ◽  
2018 ◽  
Vol 8 (3) ◽  
pp. e019338 ◽  
Author(s):  
Wei Chang ◽  
Jian-Feng Xie ◽  
Jing-Yuan Xu ◽  
Yi Yang

ObjectiveWe aim to synthesise up-to-date randomised trials to investigate the effects of levosimendan on mortality and clinical outcomes in severe sepsis and septic shock.MethodsA collection of databases including PubMed, EMBASE, Cochrane Central Register and Web of Science were searched updated to August 2017. Randomised trials were included when they pertain to the use of levosimendan in severe sepsis or septic shock compared with any category of inotropes, or as an adjunct to standard therapy with mortality reported. The primary outcome was mortality, and the secondary outcomes were clinical performances including serum lactate, cardiac function, vasopressor requirement and fluid infusion.ResultsA total of 10 studies with 1036 patients were included in this meta-analysis. The results revealed that levosimendan could not reduce mortality significantly in severe sepsis and septic shock (OR 0.89, 95% CI 0.69 to 1.16, P=0.39). Levosimendan use could reduce serum lactate more effectively, and enhance cardiac contractibility with increased cardiac index and left ventricular ejection fraction. However, its use could also increase fluid infusion but not reduce norepinephrine dose. No significant benefit in mortality could be observed of levosimendan versus dobutamine use, or in patients with proven cardiac dysfunction.ConclusionsCurrent evidence is not sufficient to support levosimendan as superior to dobutamine or as an optimal adjunct in severe sepsis and septic shock. More large-scale randomised trials are necessary to validate levosimendan use in sepsis.


Mycoses ◽  
2015 ◽  
Vol 58 (7) ◽  
pp. 399-407 ◽  
Author(s):  
Christoph Lichtenstern ◽  
Christina Herold ◽  
Markus Mieth ◽  
Thorsten Brenner ◽  
Sebastian Decker ◽  
...  

2018 ◽  
Vol 8 (3) ◽  
pp. 223-228
Author(s):  
Rozina Sultana ◽  
Tarikul Hamid ◽  
ASM Areef Ahsan ◽  
Kaniz Fatema ◽  
Fatema Ahmed ◽  
...  

Background: Lactate clearance is an important marker of global tissue hypoxia and might be used as an indicator of outcome in patients with severe sepsis and septic shock. This study was done to see the association between lactate clearance with the outcome of the patients of severe sepsis and septic shock among the patients who were admitted in the Department of Critical Care Medicine of BIRDEM General Hospital.Methods: This observational study was done in the Department of Critical Care Medicine, BIRDEM General Hospital from August 2015 to July 2016. At zero hour (during admission), first sample of serum lactate was sent and second sample after 6 hours of resuscitation for calculation of lactate clearance rate. Patients having lactate clearance e”10% were classified as high lactate clearance (HLC) and <10% were low lactate clearance (LLC).Results: Total 186 patients (male 96, female 90, mean age 63.07±14.17 years) with severe sepsis (80) and septic shock (106) were enrolled. Diabetes mellitus (DM) was the most common co morbidity (76.9%) and predominant diagnosis was pneumonia (90.3%). Among patients with septic shock, 51.9% (55/106) had LLC and 48.1% (51/106) had HLC. Among patients with severe sepsis, 28.8% (23/80) had LLC and 71.2% (57/80) had HLC. Among 57 patients of HLC group of severe sepsis, 73.6% (n= 42) were survivors and 26.3% (n=15) were non-survivor and 23 patients of LLC group of severe sepsis, 26.09% (n=6) were survivors and 73.91% (n=17) were-non survivors (p=<0.001). Among 51 patients of HLC group of septic shock, 78.43% (n=40) were survivors and 21.57% (n=11) were non-survivors and 55 patients of LLC group of septic shock, 29.09% (n=16) were survivors and 70.91% (n=39) were non-survivors (p=<0.001).Conclusion: Patients with HLC after 6 hours of management had better outcome than LLC.Birdem Med J 2018; 8(3): 223-228


Sign in / Sign up

Export Citation Format

Share Document