Admission hyperlactatemia: Causes, incidence, and impact on outcome of patients admitted in a general medical intensive care unit

Juneja, Deven; Singh, Omender; Dang, Rohit

doi:10.1016/j.jcrc.2010.11.009

Cited by 74 publications

(70 citation statements)

References 26 publications

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“…As a matter of fact, hyperlactatemia was firstly reported as a parameter for measurement of "reversibility" [16]. Then, in recent years, most reports show a prognostic value of hyperlactatemia on predicting mortality in both adults and children in lots of medical illnesses, including shock, sepsis, trauma, surgery and especially after cardiac interventions [17][18][19][20][21][22]. Although there are reports that admission hyperlactatemia predicts mortality and clinical outcome, the predictive value of a single lactate assessed on admission is controversial.…”

Section: Discussionmentioning

confidence: 99%

The reasons of hyperlactatemia on admission and relationship of the lactate levels with clinical outcomes in pediatric intensive care unit

Bağ¹,

Karaarslan²,

İşgüder³

et al. 2017

Pau Med J

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Purpose:Hyperlactatemia has been reported to predict mortality and morbidity in critically ill patients. The aim of this study is to define the reasons of hyperlactatemia on admission in critical pediatric patients, to describe a cut off value to predict mortality and to evaluate the outcomes of admission hyperlactatemia in pediatric intensive care unit. Materials and methods: Hospital records of 202 pediatric patients who had admitted to pediatric intensive care unit (Male/Female: 101/101; median age: 3 years [IQR: 9.2] ) were evaluated retrospectively, for the study. Age, gender, admission diagnosis, arterial blood gas analysis, length of stay, presence of in-hospital mortality were recorded in the study group. Hyperlactatemia was defined according to L-lactate levels defined by age. The patients with and without hyperlactatemia were compared for mortality and clinical outcomes. Results:The frequency of admission hyperlactatemia was 64.3% (n: 130). The patients with dehydration due to acute gastroenteritis, acute respiratory insufficiency and acaute cardiac insufficiency had significantly higher lactate levels compared with children with other diagnosis. Admission hyperlactatemia was not found to have a cut-off value to predict mortality by ROC analysis (Area under curve: 0.57). Moreover, hyperlactatemia was not found to effect either mortality rate or outcome in the study group. Conclusion:The results of this study indicate that admission hyperlactatemia may not be used as a predictor of either death or poor clinical outcome in pediatric intensive care units. Further there is a lack of cut off value for lactate in literature to predict outcomes in different pediatric ages. Pam Med J 2017;(1):1-6Key words: Hyperlactatemia, admission, childhood, PICU. ÖzetAmaç: Laktat yüksekliğinin kritik hasta izleminde mortalite ve morbiditeyi belirleyici olduğunu gösteren çalişmalar mevcuttur. Bu araştirmanin amaci, kritik hastaliği olan çocuklarda laktat yüksekliğinin nedenlerini belirlemek, mortaliteyi belirleyen bir eşik değer olup olmadiğini saptamak ve çocuk yoğun bakim ünitesinde laktat yüksekliğinin klinik sonuçlarini değerlendirmektir. Gereç ve yöntem: Çocuk yoğun bakim ünitesine başvuran toplam 202 olgunun (Erkek/Kiz: 101/101; median yaş: 3 [IQR: 9.2]) dosya kayitlari geriye dönük olarak incelendi. Hastalarin yaşi, cinsiyeti, başvuru tanisi, arteriyel kan gazi sonuçlari, hastanede kalma süresi, ve ölüm varliği kaydedildi. Laktat yüksekliği, yaş gruplarina göre düzeylerine göre tanimlandi. Başvuruda laktat yüksekliği olan ve olmayan olgular, ölüm oranlari ve klinik sonuçlar açisindan karşilaştirildi. Bulgular: Başvuruda saptanan hiperlaktatemi sikliği %64.3 (n: 130) idi. Akut gastroenterite bağli dehidratasyon, akut solunumsal yetmezlik ve akut kalp yetmezliği olanlarda laktat düzeyleri diğer tanilarla karşilaştirildiğinda anlamli olarak daha yüksek bulundu. ROC analizi ile mortaliteyi belirleyecek herhangi bir eşik değer saptanmadi (eğri alti alan: 0.57). Ayrica, hiperlaktateminin mortalite ve klinik sonuçla...

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Section: Discussionmentioning

confidence: 99%

The reasons of hyperlactatemia on admission and relationship of the lactate levels with clinical outcomes in pediatric intensive care unit

Bağ¹,

Karaarslan²,

İşgüder³

et al. 2017

Pau Med J

View full text Add to dashboard Cite

show abstract

“…Shock was the most common cause for non-surgical hyperlactatemia, followed by respiratory and renal failures in one study (Juneja et al, 2011). Patients with or without shock who had higher blood lactate levels on admission to the ICU were also found to have higher APACHE II scores, and a greater need for vasopressors or renal replacement therapy and mechanical ventilation, (Juneja et al, 2011).…”

Section: Nonoperative Factorsmentioning

confidence: 96%

“…Either systemic or regional hypoperfusion may result in hyperlactatemia (Mizock & Falk, 1992). The major causes of secondary hyperlactatemia are shock (cardiogenic, septic, hypovolemic), regional hypoperfusion (limb, mesenteric ischemia), severe hypoxemia, severe anemia, carbon monoxide poisoning, and severe respiratory acidosis (asthma) (Juneja et al, 2011;Mizock, 1989). The relationship between regional oxyhemoglobin saturation (rS0 2 ) and lactate is exponential in nature, as demonstrated in a study which aimed to determine whether there is a relationship between rS0 2 measured at various body locations by near-infrared spectroscopy and blood lactate level in children after cardiac surgery (Chakravarti et al, 2009).…”

Section: Secondary (Type A)mentioning

confidence: 99%

“…The prevalence and incidence of hyperlactatemia upon general admission to the ICU Hyperlactatemia was present in 199 of 653 (30.47%) patients, admitted over 15 months to an 8-bed general ICU of a tertiary care hospital in India (Juneja et al, 2011). Khosravani et al (2009) documented the incidence of hyperlactatemia in critically ill patients and found a significantly variation according to the major admitting diagnostic category.…”

Section: The Prevalence and Incidence Of Postoperative Hyperlactatemiamentioning

confidence: 99%

“…Sensitivity and specificity of lactate >2 mmol/L (18 mg/dL) to predict ICU mortality was 74.8% and 77.8%, respectively. The odds ratio for dying in patients with hyperlactatemia was 10.39 (95% CI, 6.378-16.925), with a relative risk of 1.538 (95% CI, 1.374-1.721) (Juneja et al, 2011). In one multicenter, open-label randomized controlled study on patients who had hyperlactatemia on general ICU admission, lactate monitoring followed by hyperlactatemia-targeted treatment significantly reduced length of stay in the ICU.…”

Section: Generalmentioning

confidence: 99%

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Admission hyperlactatemia: Causes, incidence, and impact on outcome of patients admitted in a general medical intensive care unit

Cited by 74 publications

References 26 publications

The reasons of hyperlactatemia on admission and relationship of the lactate levels with clinical outcomes in pediatric intensive care unit

The reasons of hyperlactatemia on admission and relationship of the lactate levels with clinical outcomes in pediatric intensive care unit

The Physiology and the Clinical Significance of Postoperative Hyperlactatemia After Pediatric Cardiac Surgery

Lactate in Critically Ill Patients: At the Crossroads Between Perfusion and Metabolism

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