scholarly journals To Determine Blood Lactate Levels in Patients with Sepsis Admitted to a Respiratory Intensive Care Unit and to Correlate with their Hospital Outcomes

2018 ◽  
Vol 4 (2) ◽  
Author(s):  
Asati Amit K ◽  
Gupta Rajnish ◽  
Behera D
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Blood Lactate ◽  
Hospital Outcomes ◽  
Respiratory Intensive Care Unit ◽  
Lactate Levels ◽  
Blood Lactate Levels

scholarly journals Analysis of serum lactate levels to predict in hospital mortality in critically ill children admitted to pediatric intensive care unit

2019 ◽  
Vol 6 (6) ◽  
pp. 2538
Author(s):  
Trilok Rao Srigiri ◽  
Partha Saradhi Manyam ◽  
Uma Mahesh ◽  
Gangadhar Belavadi
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Hospital Mortality ◽  
Blood Lactate ◽  
Critically Ill ◽  
Pediatric Intensive Care ◽  
Critically Ill Children ◽  
Lactate Levels ◽  
Blood Lactate Levels ◽  
High Lactate

Background: The predictive significance of lactate measurement at admission for mortality in critically ill children remains uncertain. Authors  objectives was to study evaluated the predictive value of blood lactate levels at admission and determined the cut-off values for predicting in-hospital mortality in the critically ill pediatric population.Methods: A prospective observational study was done in 100 critically ill admissions to the pediatric intensive care unit (PICU), requiring hemodynamic/respiratory support.  The chi-square test for categorical variables performs the comparison.Results:  Out of 100 patients, 22 (22%) expired. Mortality is highest in 10-16 age (7%). In the non-survivor group, the majority of patients were diagnosed as pneumonia (7.5%). Median lactate levels in non-survivors are 4.5 at admission when compared to 2.0 in survivors (p<0.001). The mortality rates left rate in the high lactate group (73%) is more when compared to intermediate (20%) and low-level groups (7%). Blood lactate was 75% sensitive and 90% specific at the optimal cut-off value of 33.7 mg/dl. The positive likelihood ratio of predicting death is more with a high lactate level (7.5) when compared to intermediate (0.8) and low levels (0.08). Sensitivity and Specificity with elevated lactate levels is the mortality 24 hrs (89%, 92%) than at admission (75%, 90%). The AUROC values with the admission lactate level are 0.86, and after 24 hrs are 0.95.Conclusions: Blood lactate levels at admission predict mortality in critically ill children requiring hemodynamic/respiratory support.

scholarly journals Intraoperative changes in blood lactate levels are associated with worse short-term outcomes after cardiac surgery with cardiopulmonary bypass

Perfusion ◽  
2019 ◽  
Vol 34 (8) ◽  
pp. 640-650 ◽  
Author(s):  
Benoit Duval ◽  
Thibaud Besnard ◽  
Stefano Mion ◽  
Sébastien Leuillet ◽  
Olivier Jecker ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Cardiac Surgery ◽  
Intensive Care ◽  
Blood Lactate ◽  
Lactate Level ◽  
Blood Lactate Level ◽  
Short Term ◽  
Laboratory Test Results ◽  
Lactate Levels ◽  
Blood Lactate Levels

Background: A high perioperative blood lactate level has been reported to be associated with poor outcomes after cardiac surgery. More than isolated peaks of lactate values, it should be more interesting to take into account changes in intraoperative blood lactate level (∆Lact). This large-scale retrospective study evaluated the relationship between ∆Lact and overall intensive care unit morbidity and 30-day all-cause mortality. Methods: Perioperative data from consecutive patients undergoing on-pump cardiac surgery between September 2010 and June 2016 were retrospectively analysed through our institutional database including clinical, transfusion and laboratory test results implemented prospectively by physicians. Blood lactate levels were initially measured after induction of anaesthesia (baseline) and periodically during the surgery. The ∆Lact was defined as the difference between the highest intraoperative blood lactate and the baseline lactate level and offered the opportunity to stratify patients into four subgroups: ⩽0, 0.1-0.9, 1-1.9 and ⩾2 mmol L−1. Results: From the 7,795 patients found eligible during the study period, 7,447 patients were analysed. The median ∆Lact of our patients was 0.6 (0.3-1) mmol L−1. Most of the studied patients (65.9%) exhibited a ∆Lact between 0.1 and 0.9 mmol L−1. A concentration-dependent relationship was observed between ∆Lact and intensive care unit morbidity and 30-day mortality. After adjustment for co-variables, all ∆Lact > 0 was associated with an increase in overall intensive care unit morbidity. An independent relationship was also found between ∆Lact and 30-day mortality as of a 1 mmol L−1 increase. Conclusion: Our results suggest that ∆Lact is associated with poor short-term outcomes in adult cardiac surgical patients.

scholarly journals In-Hospital Outcomes in Patients Admitted to the Intensive Care Unit after a Return Visit to the Emergency Department

Healthcare ◽  
2021 ◽  
Vol 9 (4) ◽  
pp. 431
Author(s):  
Chun-Fu Lin ◽  
Yi-Syun Huang ◽  
Ming-Ta Tsai ◽  
Kuan-Han Wu ◽  
Chien-Fu Lin ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Emergency Department ◽  
Regression Analysis ◽  
Intensive Care ◽  
Medical Cost ◽  
Total Medical Cost ◽  
Hospital Outcomes ◽  
Return Visit ◽  
Icu Admission ◽  
Ed Visits

Background: Intensive care unit (ICU) admission following a short-term emergency department (ED) revisit has been considered a particularly undesirable outcome among return-visit patients, although their in-hospital prognosis has not been discussed. We aimed to compare clinical outcomes between adult patients admitted to the ICU after unscheduled ED revisits and those admitted during index ED visits. Method: This retrospective study was conducted at two tertiary medical centers in Taiwan from 1 January 2016 to 31 December 2017. All adult non-trauma patients admitted to the ICU directly via the ED during the study period were included and divided into two comparison groups: patients admitted to the ICU during index ED visits and those admitted to the ICU during return ED visits. The outcomes of interest included in-hospital mortality, mechanical ventilation (MV) support, profound shock, hospital length of stay (HLOS), and total medical cost. Results: Altogether, 12,075 patients with a mean (standard deviation) age of 64.6 (15.7) years were included. Among these, 5.3% were admitted to the ICU following a return ED visit within 14 days and 3.1% were admitted following a return ED visit within 7 days. After adjusting for confounding factors for multivariate regression analysis, ICU admission following an ED revisit within 14 days was not associated with an increased mortality rate (adjusted odds ratio (aOR): 1.08, 95% confidence interval (CI): 0.89 to 1.32), MV support (aOR: 1.06, 95% CI: 0.89 to 1.26), profound shock (aOR: 0.99, 95% CI: 0.84 to 1.18), prolonged HLOS (difference: 0.04 days, 95% CI: −1.02 to 1.09), and increased total medical cost (difference: USD 361, 95% CI: −303 to 1025). Similar results were observed after the regression analysis in patients that had a 7-day return visit. Conclusion: ICU admission following a return ED visit was not associated with major in-hospital outcomes including mortality, MV support, shock, increased HLOS, or medical cost. Although ICU admissions following ED revisits are considered serious adverse events, they may not indicate poor prognosis in ED practice.

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