Adipose Tissue Lactate Clearance but Not Blood Lactate Clearance Is Associated with Clinical Outcome in Sepsis or Septic Shock during the Post-Resuscitation Period

Ilias, Ιoannis; Apollonatou, Sofia; Vassiliadi, Dimitra; Nikitas, Nikitas; Θεοδωρακοπούλου, Μαρία; Diamantakis, A; Κοτανίδου, Αναστασία; Dimopoulou, Ioanna

doi:10.3390/metabo8020028

Cited by 5 publications

(5 citation statements)

References 37 publications

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“…Since the same reason, AUC of lactate area score might lower than other studies. The overall 28-day mortality was higher than that of other similarly designed studies involving patients with septic shock (26.2%–36%) [17,23,24]. One more important limitation was that the calculation method is not easy.…”

Section: Discussionmentioning

confidence: 94%

Utility of the Early Lactate Area Score as a Prognostic Marker for Septic Shock Patients in the Emergency Department

Yu¹,

Yoo²,

Lee

et al. 2019

Acute Crit Care

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Background The current Surviving Sepsis Campaign guidelines recommend the remeasurement of lactate levels if the initial lactate level is elevated; however, the prognostic value of lactate kinetics is limited and inconsistent. We attempted to determine the efficacy of the lactate area score (calculated from repeated lactate measurements during initial resuscitation) as a prognostic marker of septic shock in the emergency department (ED).Methods We performed a retrospective study of adult patients with septic shock in the ED of a single tertiary medical center. Serial lactate levels were measured five times within 12 hours. We also compared the initial lactate level, maximum lactate level, and lactate area score. The lactate area score was defined as the sum of the area under the curve measured at 2, 4, 6, and 12 hours following the initial measurement.Results A total of 362 patients were enrolled in this study, and the overall 28-day mortality was 31.8%. The lactate area score of serial lactate levels as well as the initial (median [interquartile range], 4.9 [3.4 to 10.5]; P=0.003) and maximum (7.3 [4.2 to 13.2]; P<0.001) lactate levels were significantly higher in the non-survivor group. However, in multivariate analysis, only the lactate area score (odds ratio, 1.013; 95% confidence interval, 1.007 to 1.019) was significantly associated with 28-day mortality.Conclusions The early lactate area score may be a possible prognostic marker for predicting the 28-day mortality of adult septic shock patients. Further prospective interventional studies should be conducted to validate our results.

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Section: Discussionmentioning

confidence: 94%

Utility of the Early Lactate Area Score as a Prognostic Marker for Septic Shock Patients in the Emergency Department

Yu¹,

Yoo²,

Lee

et al. 2019

Acute Crit Care

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“…Once acute and critical illness-related hypoxia occurs, pyruvate after glucose metabolism could hardly complete the metabolic process due to hypoxia. Lactic acid accordingly accumulates in the body and increases the risk of lactic acidosis, and the lactate clearance rate indicates the oxygen supply and consumption of the body [ 14 – 16 ]. Pct, a precursor of calcitonin, is composed of multiple amino acids and tends to increase once exposed to bacterial infection and is correlated with the severity of the disease.…”

Section: Discussionmentioning

confidence: 99%

Expression and Clinical Trends of Pct Combined with Lactate Clearance in Sepsis

Chen

Yan

2022

Evidence-Based Complementary and Alternative Medicine

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Objective. To study the expression and clinical trend of procalcitonin (Pct) + lactate clearance in sepsis. Methods. A total of 63 septic shock patients enrolled in our hospital from March 2018 to March 2021 were recruited as group A, and the 87 septic patients admitted during the same period were recruited as group B. The Pct, lactic acid, and lactate clearance were compared between the two groups. Results. The Pct and lactic acid in group A were higher than those in group B at the time of diagnosis, 1 d, 2 d, and 3 d after treatment, but the lactate clearance rate at 1 d, 2 d, and 3 d after treatment was lower than that in group B ( P < 0.05 ). The Pct and lactate at the time of diagnosis, 1 d, 2 d, and 3 d after treatment in the good prognosis group were lower than those in the poor prognosis group, but the lactate clearance rate at 1 d, 2 d, and 3 d after treatment was higher than that in the poor prognosis group ( P < 0.05 ). Disease severity and prognosis were positively correlated with Pct and lactate, but negatively correlated with lactate clearance rate ( P < 0.05 ). Conclusions. Pct and lactate clearance rate might serve as accurate predictors of the severity of sepsis and prognosis. It merits promotion in clinical setting.

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“…Recent evidence suggests that lactate accumulates at sites of chronic inflammation and that these levels can increase via metabolic reprogramming ( Pucino et al, 2019 ). Clinically, it has been known that lactate levels can be used as a surrogate to measure tissue perfusion; and its elevation has been shown to be associated with an increased risk of death in infection, sepsis, trauma, and patients undergoing open surgical procedures ( Nguyen et al, 2004 ; Ding et al, 2018 ; Ilias et al, 2018 ).…”

Section: Introductionmentioning

confidence: 99%

Construction of a lactate-related prognostic signature for predicting prognosis after surgical repair for acute type a aortic dissection

Wang

Li²,

Xu³

et al. 2022

Front. Physiol.

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Background: Serum lactate is commonly measured in the perioperative period in patients who have undergone surgery for an acute type A aortic dissection (ATAAD). However, conflicting data has been reported as to whether lactate elevation is associated with short-term prognosis. The aim of the current study was to determine the association between perioperative arterial lactate levels and postoperative 30-day mortality.Methods: Patients who underwent repair of a ATAAD at our institution were retrospectively screened and those with comprehensive measurements of serum lactate before surgery and at 0, 1, 3, 6, 12, and 24 h after surgery in the intensive care unit (ICU) were selected for the analysis. Patients’ demographic features and outcomes were reviewed to determine risk factors associated with 30-day mortality using logistic regression modeling. The association between serum lactate levels at different time points and 30-day mortality were analyzed by receiver-operating characteristic curves.Results: 513 patients were identified and retrospectively analyzed for this study including 66 patients (12.9%) who died within 30 days after surgery. Patients who died within 30 days after surgery had elevated lactate levels measured before surgery and at 0, 1, 3, 6, 12, and 24 h after their ICU stay. Lactate measured at 24 h post ICU admission (odds ratio, 2.131; 95% confidence interval, 1.346–3.374; p = 0.001) was a predictor of 30-day mortality. The area under the curve (AUC) for 30-day mortality with lactate levels at 12 h and 24 h post ICU stay were 0.820 and 0.805, respectively.Conclusion: Early elevation of lactate level is correlated with increased 30-day mortality in patients who received ATAAD surgical repair.

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Adipose Tissue Lactate Clearance but Not Blood Lactate Clearance Is Associated with Clinical Outcome in Sepsis or Septic Shock during the Post-Resuscitation Period

Cited by 5 publications

References 37 publications

Utility of the Early Lactate Area Score as a Prognostic Marker for Septic Shock Patients in the Emergency Department

Utility of the Early Lactate Area Score as a Prognostic Marker for Septic Shock Patients in the Emergency Department

Expression and Clinical Trends of Pct Combined with Lactate Clearance in Sepsis

Construction of a lactate-related prognostic signature for predicting prognosis after surgical repair for acute type a aortic dissection

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