scholarly journals Early Lactate Clearance Rate is an Indicator of Outcome in Severe Sepsis and Septic Shock

2018 ◽  
Vol 8 (3) ◽  
pp. 223-228
Author(s):  
Rozina Sultana ◽  
Tarikul Hamid ◽  
ASM Areef Ahsan ◽  
Kaniz Fatema ◽  
Fatema Ahmed ◽  
...  
Keyword(s):  
Septic Shock ◽  
Critical Care ◽  
Severe Sepsis ◽  
Clearance Rate ◽  
Lactate Clearance ◽  
Serum Lactate ◽  
Critical Care Medicine ◽  
Co Morbidity ◽  
Sepsis And Septic Shock ◽  
Important Marker

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

Diagnostic Validity of Ratio between Differences of Central Venous to Arterial CO2 and Arterial to Central Venous O2 Content in Diagnosis of Anaerobic Metabolism among Septic Patients

2021 ◽  
Vol 8 (1) ◽  
pp. 34-38
Author(s):  
Subroto Kumar Sarker ◽  
Umme Kulsum Choudhury ◽  
Mohammad Mohsin ◽  
Subrata Kumar Mondal ◽  
Muslema Begum
Keyword(s):  
Septic Shock ◽  
Severe Sepsis ◽  
Intensive Care ◽  
Anaerobic Metabolism ◽  
Venous Blood ◽  
Blood Gases ◽  
Serum Lactate ◽  
Central Venous ◽  
College Hospital ◽  
Sepsis And Septic Shock

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

scholarly journals Evolutive standard base excess and serum lactate level in severe sepsis and septic shock patients resuscitated with early goal-directed therapy: still outcome markers?

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 ◽  
...  
Keyword(s):  
Septic Shock ◽  
Severe Sepsis ◽  
Base Excess ◽  
Serum Lactate ◽  
Serum Lactate Level ◽  
Goal Directed Therapy ◽  
Early Goal Directed Therapy ◽  
Standard Base Excess ◽  
Standard Base ◽  
Sepsis And Septic Shock

The Usefulness of Lactate Clearance Adjusted to Time as a Predictive Index in Patients with Severe Sepsis and Septic Shock

2009 ◽  
Vol 24 (3) ◽  
pp. 134 ◽  
Author(s):  
Jung-Hwan Ahn ◽  
Sang-Cheon Choi ◽  
Young-Gi Min ◽  
Yoon-Seok Jung ◽  
Sung Hee Chung ◽  
...  
Keyword(s):  
Septic Shock ◽  
Severe Sepsis ◽  
Lactate Clearance ◽  
Predictive Index ◽  
Sepsis And Septic Shock

scholarly journals ADVANCED CRITICAL CARE TRANSTHORACIC ECHOCARDIOGRAPHY IN SEVERE SEPSIS AND SEPTIC SHOCK

CHEST Journal ◽  
2009 ◽  
Vol 136 (4) ◽  
pp. 128S
Author(s):  
Joel E. Pittman ◽  
Colin Grissom ◽  
Samuel Brown ◽  
Chad Cole ◽  
Ellie Hirshberg ◽  
...  
Keyword(s):  
Septic Shock ◽  
Critical Care ◽  
Severe Sepsis ◽  
Transthoracic Echocardiography ◽  
Sepsis And Septic Shock

scholarly journals STUDY OF SERUM LACTATE LEVELS IN PATIENTS WITH SEPSIS ON THE BASIS OF SURVIVAL AND NON-SURVIVAL

2021 ◽  
pp. 8-10
Author(s):  
Anisha Tanwar ◽  
Bushra Fiza ◽  
Bhupesh Medatwal ◽  
Rubal Singh ◽  
Maheep Sinha
Keyword(s):  
Septic Shock ◽  
Severe Sepsis ◽  
Lactic Acid ◽  
Survival Rate ◽  
Lactate Concentration ◽  
Serum Lactate ◽  
Mortality Prediction ◽  
P Value ◽  
Lactate Levels ◽  
Sepsis And Septic Shock

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.

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