Contribution of the Pre-Hospital Blood Lactate Level in the Pre-Hospital Orientation of Septic Shock: The LAPHSUS Study

Background: Assessment of disease severity in patients with septic shock (SS) is crucial in determining optimal level of care. In both pre- and in-hospital settings, the clinical picture alone is not sufficient for assessing disease severity and outcomes. Because blood lactate level is included in the clinical criteria of SS it should be considered to improve the assessment of its severity. This study aims to investigate the relationship between pre-hospital blood lactate level and 30-day mortality in patients with SS. Methods: From 15 April 2017 to 15 April 2019, patients with SS requiring pre-hospital Mobile Intensive Care Unit intervention (MICU) were prospectively included in the LAPHSUS study, an observational, non-randomized controlled study. Pre-hospital blood lactate levels were measured at the time of first contact between the patients and the MICU. Results: Among the 183 patients with septic shock requiring action by the MICU drawn at random from LAPHSUS study patients, six (3%) were lost to follow-up on the 30th day and thus 177 (97%) were analyzed for blood lactate levels (mean age 70 ± 14 years). Pulmonary, urinary and digestive infections were probably the cause of the SS in respectively 58%, 21% and 11% of the cases. The 30-day overall mortality was 32%. Mean pre-hospital lactatemia was significantly different between patients who died and those who survived (respectively 7.1 ± 4.0 mmol/L vs. 5.9 ± 3.5 mmol/L, p < 10−3). Using Cox regression analysis adjusted for potential confounders we showed that a pre-hospital blood lactate level ≥ 4 mmol/L significantly predicted 30-day mortality in patients with SS (adjusted hazard ratio = 2.37, 95%CI (1.01–5.57), p = 0.04). Conclusion: In this study, we showed that pre-hospital lactatemia predicts 30-day mortality in patients with septic shock handled by the MICU. Further studies will be needed to evaluate if pre-hospital lactatemia alone or combined with clinical scores could affect the triage decision-making process for those patients.

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Comparison of serial blood lactate level between dengue shock syndrome and dengue hemorrhagic fever (evaluation of prognostic value)

Paediatrica Indonesiana ◽

10.14238/pi47.4.2007.150-5 ◽

2007 ◽

Vol 47 (4) ◽

pp. 150 ◽

Cited By ~ 1

Author(s):

M. Tatang Puspanjono ◽

Abdul Latief ◽

Alan R. Tumbelaka ◽

Sudigdo Sastroasmoro ◽

Hartono Gunardi

Keyword(s):

Oxygen Saturation ◽

Blood Lactate ◽

Dengue Hemorrhagic Fever ◽

Lactate Level ◽

Venous Blood ◽

Dengue Shock Syndrome ◽

Hemorrhagic Fever ◽

Blood Lactate Level ◽

Cross Sectional ◽

The Difference

Background Dengue shock syndrome (DSS) mortality is still high.Monitoring of blood lactate level is important to evaluate shock.Objectives The study were to review the difference between bloodlactate level of DSS and that of dengue hemorrhagic fever (DHF),to correlate blood lactate level with hypoxia state as shock riskfactors (PaO 2 , oxygen saturation, and anion gap) and to determinethe cut-off point of blood lactate level to predict shock.Methods The study was carried out at the Department of ChildHealth, Medical School, University of Indonesia, CiptoMangunkusumo Hospital, Jakarta, from January until July 2006.Three mL venous blood specimen was collected from all subjectsfor peripheral blood, blood gasses, serology, and blood lactateexaminations. This study consisted of a retrospective cohort anda cross sectional method. Data were analyzed with Chi-squaretest. Continous data tested using Mann-Whitney method. Toknow the correlation between blood lactate level and shock riskfactors we use logistic regression test.Results In DSS group, 73% shows hyperlactatemia (lactate =2mmol/L). Conversion of lactate means between two groups issignificantly different from day one to day two and three. Therewas a negative correlation between lactate level and pO 2 andoxygen saturation. Oxygen saturation is the only value that hasclinical correlation. Regressions analysis can be applied using Y= 7.05–0.05 X equation. The cut-off point of lactate level asmarker for shock by using ROC curve is 32.015 mmol/L with 70%sensitivity and 83.3% specificity.Conclusions Hyperlactatemia in DSS can be considered as a signfor unappropriate treatment of shock. Blood lactate level can beused as a biochemical marker for tissue hypoxia, to assess severityof the disease, as monitoring of treatment, and has prognosticvalue of DHF cases.

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Multisite Near-Infrared Spectroscopy Predicts Elevated Blood Lactate Level in Children After Cardiac Surgery

Journal of Cardiothoracic and Vascular Anesthesia ◽

10.1053/j.jvca.2009.03.014 ◽

2009 ◽

Vol 23 (5) ◽

pp. 663-667 ◽

Cited By ~ 82

Author(s):

Sujata B. Chakravarti ◽

Alexander J.C. Mittnacht ◽

Jason C. Katz ◽

Khahn Nguyen ◽

Umesh Joashi ◽

...

Keyword(s):

Cardiac Surgery ◽

Infrared Spectroscopy ◽

Blood Lactate ◽

Near Infrared Spectroscopy ◽

Lactate Level ◽

Near Infrared ◽

Blood Lactate Level ◽

Elevated Blood

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Muscle fatigue evaluation method of driver at long time driving based on blood lactate level increase

Transactions of the JSME (in Japanese) ◽

10.1299/transjsme.19-00433 ◽

2020 ◽

Vol 86 (889) ◽

pp. 19-00433-19-00433

Author(s):

Takumi YAMAKAWA ◽

Soichiro HAYAKAWA ◽

Katsuhiro ASANO ◽

Shigeyoshi TSUTSUMI ◽

Ryojun IKEURA

Keyword(s):

Muscle Fatigue ◽

Blood Lactate ◽

Lactate Level ◽

Evaluation Method ◽

Blood Lactate Level ◽

Level Increase ◽

Long Time ◽

Fatigue Evaluation

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Abstract 339: Capillary Transmitted Light Intensity for the Monitoring of Tissue Perfusion: CLIP Study

Circulation ◽

10.1161/circ.130.suppl_2.339 ◽

2014 ◽

Vol 130 (suppl_2) ◽

Author(s):

Naoto Morimura ◽

Tetsuya Sakamoto ◽

Kyoko Matsumori ◽

Kohei Takahashi ◽

Tomoki Doi ◽

...

Keyword(s):

Light Intensity ◽

Blood Lactate ◽

Critically Ill Patients ◽

Pulse Oximeter ◽

Predictive Value ◽

Lactate Level ◽

Tissue Perfusion ◽

Blood Lactate Level ◽

Arterial Blood ◽

Arterial Blood Lactate

Background: We developed a new device for quantifying capillary refill time (CRT) by applying the pulse oximeter principle, and reported the excellent correlation between quantitative CRT (Q-CRT) and tissue hypoperfusion status as represented by arterial blood lactate levels in critically ill patients in the pilot study. Methods: Diagnostic accuracy study was undergone in ICU of a tertiary emergency medical center. While the pulse oxygen saturation sensor was placed on the finger of the patients, transmitted light intensity was measured with a pulse oximeter (OLV-3100, Nihon Kohden Corp., Japan) before start and during compression of the finger. Correlation between delta Ab, defined as the absorbance of light intensity of infra-red (A-ir) minus that of red (A-r), and arterial blood lactate level was analyzed. Results: The delta Ab was analyzed a total of 69 waveforms in 23 patients. The sensitivity, specificity, positive predictive value, and negative predictive value of the delta Ab less than 0.06 for predicting a lactate level more than 2.0 mmol/l were 100%, 93%, 89%, 100%, respectively. Conclusions: The delta Ab was well correlated to high level of blood lactate level in critically ill patients. Further study will confirm to place the delta Ab as one of non-invasive predictors of tissue perfusion status.

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Anaerobic capacity and blood lactate level of former elite athletes

IOP Conference Series Materials Science and Engineering ◽

10.1088/1757-899x/434/1/012157 ◽

2018 ◽

Vol 434 ◽

pp. 012157

Author(s):

N Nasuka ◽

I Santosa ◽

A Setiowati ◽

F Indrawati

Keyword(s):

Blood Lactate ◽

Lactate Level ◽

Elite Athletes ◽

Anaerobic Capacity ◽

Blood Lactate Level ◽

Former Elite Athletes

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Increased Blood Lactate Level Deteriorates Running Economy in World Class Endurance Athletes

The Journal of Strength and Conditioning Research ◽

10.1519/jsc.0000000000001349 ◽

2016 ◽

Vol 30 (5) ◽

pp. 1373-1378 ◽

Cited By ~ 15

Author(s):

Jan Hoff ◽

Øyvind Støren ◽

Arnstein Finstad ◽

Eivind Wang ◽

Jan Helgerud

Keyword(s):

Blood Lactate ◽

Lactate Level ◽

Blood Lactate Level ◽

Running Economy ◽

Endurance Athletes ◽

World Class

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Blood Lactate Level as Predictor of Early Outcome after Cardiac Surgery under Cardiopulmonary Bypass

University Heart Journal ◽

10.3329/uhj.v13i2.37659 ◽

2018 ◽

Vol 13 (2) ◽

pp. 50-54

Author(s):

Md Abul Kalam Azad ◽

Md Abul Quashem ◽

Md Rezaul Karim ◽

Md Kamrul Hasan

Keyword(s):

Cardiac Surgery ◽

Cardiopulmonary Bypass ◽

Blood Lactate ◽

Lactate Level ◽

Prolonged Mechanical Ventilation ◽

Blood Lactate Level ◽

Binary Logistic Regression Analysis ◽

Early Outcome ◽

Icu Transfer ◽

Adult Cardiac Surgery

We examined the hypothesis that high blood lactate level in ICU patient after adult cardiac surgery under cardiopulmonary bypass is associated with early adverse outcome. The objective of this study was to evaluate whether blood lactate level after cardiac surgery is predictor of the early outcome after adult cardiac surgery under CPB. In this prospective observational study total 100 patients were enrolled who underwent elective cardiac surgery under CPB as per inclusion and exclusion criteria. Blood lactate levels > 3mmol/ L 6 hours after ICU transfer were present in 57(57%) patients. The binary logistic regression analysis showed that blood lactate level 6 hours after ICU transfer is an independent predictor for prolonged mechanical ventilation time (OR 2.417, 95% CI 1.272 - 4.596, p = .007), prolonged ICU stay (OR 1.562, 95% CI 1.181 - 2.067, p = .002), neurological deficit (OR 2.432, 95% CI 1.539 - 3.843, p = .001), pulmonary complication (OR 1.301, 95% CI 1.011 - 1.676, p = .041), arrhythmia (OR 1.444, 95% CI 1.102 - 1.893, p = .008), renal dysfunction (OR 1.838, 95% CI 1.352 - 2.497, p = .001) and mortality (OR 1.822, 95% CI 1.123- 2.955, p = .015). In conclusion, blood lactate level 6 hours after ICU transfer is an independent risk factor for worse outcomes in adult patients including mortality after cardiac surgery under CPB.University Heart Journal Vol. 13, No. 2, July 2017; 50-54

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