Clinical use of plasma lactate concentration. Part 2: Prognostic and diagnostic utility and the clinical management of hyperlactatemia

Rosenstein, Patricia G.; Tennent‐Brown, Brett; Hughes, Dez

doi:10.1111/vec.12706

Cited by 31 publications

(34 citation statements)

References 202 publications

(498 reference statements)

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“…The association between elevated lactate plasma concentration at admission and mortality has been well-documented in dogs, with non-survivors noted to have significantly higher lactate concentration compared to survivors. Furthermore, lactate concentration is a significant predictor of mortality in the acute patient physiologic and laboratory evaluation scoring system, a veterinary disease severity scoring system (37,38). It has been reported, however, that subsequent lactate level measurement outperformed the single measurement at admission, so it is now clear that a greater risk of death is associated with persistent hyperlactatemia rather than a single time point finding of elevated lactate concentration (38).…”

Section: Discussionmentioning

confidence: 99%

“…Furthermore, lactate concentration is a significant predictor of mortality in the acute patient physiologic and laboratory evaluation scoring system, a veterinary disease severity scoring system (37,38). It has been reported, however, that subsequent lactate level measurement outperformed the single measurement at admission, so it is now clear that a greater risk of death is associated with persistent hyperlactatemia rather than a single time point finding of elevated lactate concentration (38). These observations may explain the absence of a significant result in our study, given that lactate concentrations were evaluated only at admission and further measurements were not entered into the analysis.…”

Section: Discussionmentioning

confidence: 99%

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Analysis of Early Assessable Risk Factors for Poor Outcome in Dogs With Cluster Seizures and Status Epilepticus

et al. 2020

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Status epileptics (SE) and cluster seizures (CS) are serious neurological emergencies associated with poor outcome in epileptic patients. Data on risk factors associated with outcome in epileptic patients affected by CS and SE have not been studied extensively to date. In the present retrospective study potential risk factors predictive of negative outcome in a population of dogs affected by CS and SE were analyzed. Ninety-three dogs were included in the study: 21/93 patients (23%) presented with SE and 72/93 (77%) with CS. Based on multivariate statistical analysis, factors statistically associated with a poor outcome were the occurrence of the first epileptic seizure outside the defined idiopathic interval (6 months−6 years), a condition of hyperthermia at presentation and the absence of previous antiepileptic drugs (AEDs) in case of previous history of seizures. The results of the present study implement data on risk factors associated with poor outcome in dogs affected by CS or SE and can aid in the creation of an ad hoc scoring system, similar to systems currently applied in human medicine upon hospital admission to benchmark performances and establish protocols for triage and therapeutic management.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Analysis of Early Assessable Risk Factors for Poor Outcome in Dogs With Cluster Seizures and Status Epilepticus

et al. 2020

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“…Once considered a simple by-product of anaerobic metabolism, lactate is now recognized as an important intermediate in cellular bioenergetics [ 1 ]. Clinically, lactate is now used as a prognostic indicator for hypoperfusion due to its almost proportional production relationship with the presence of oxygen in tissues.…”

Section: Introductionmentioning

confidence: 99%

Identification and Quantitative Determination of Lactate Using Optical Spectroscopy—Towards a Noninvasive Tool for Early Recognition of Sepsis

Budidha

Mamouei

Baishya

et al. 2020

Sensors

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Uninterrupted monitoring of serum lactate levels is a prerequisite in the critical care of patients prone to sepsis, cardiogenic shock, cardiac arrest, or severe lung disease. Yet there exists no device to continuously measure blood lactate in clinical practice. Optical spectroscopy together with multivariate analysis is proposed as a viable noninvasive tool for estimation of lactate in blood. As an initial step towards this goal, we inspected the plausibility of predicting the concentration of sodium lactate (NaLac) from the UV/visible, near-infrared (NIR), and mid-infrared (MIR) spectra of 37 isotonic phosphate-buffered saline (PBS) samples containing NaLac ranging from 0 to 20 mmol/L. UV/visible (300–800 nm) and NIR (800–2600 nm) spectra of PBS samples were collected using the PerkinElmer Lambda 1050 dual-beam spectrophotometer, while MIR (4000–500 cm−1) spectra were collected using the Spectrum two FTIR spectrometer. Absorption bands in the spectra of all three regions were identified and functional groups were assigned. The concentration of lactate in samples was predicted using the Partial Least-Squares (PLS) regression analysis and leave-one-out cross-validation. The regression analysis showed a correlation coefficient (R2) of 0.926, 0.977, and 0.992 for UV/visible, NIR, and MIR spectra, respectively, between the predicted and reference samples. The RMSECV of UV/visible, NIR, and MIR spectra was 1.59, 0.89, and 0.49 mmol/L, respectively. The results indicate that optical spectroscopy together with multivariate models can achieve a superior technique in assessing lactate concentrations.

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“…A recent study reviewed the human and veterinary literature on the utility of lactate as a prognostic indicator and a therapeutic guide, lactate measurement in body fluids other than plasma or blood, and the clinical management of lactate levels in different species. The authors concluded that lactate used as a therapeutic guide is relatively uninvestigated in dogs, cats, and horses, and that it is a valuable triage and risk stratification tool (ROSENSTEIN et al, 2018). The inability to reduce lactate levels by at least 50% at 6 hours was significantly associated with mortality in univariate analysis in hyperlactatemic dogs classified as critically ill according to the definition of the American Society of Anesthesiologists (STEVENSON et al, 2007).…”

Section: Resultsmentioning

confidence: 99%

Clinical and hematological prognostic factors in dogs with parvoviral enteritis and sepsis

Alves

Barbosa

Coelho

et al. 2019

SCA

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Parvoviral enteritis is a common viral infection in dogs and is associated with many clinical and hematological changes. Bacterial translocation is a common complication and may result in sepsis. The objective of this study is to determine the presence of clinical and hematological factors associated with the risk of death in puppies with naturally occurring parvoviral enteritis and sepsis. Twenty-four dogs with parvoviral enteritis confirmed by chromatographic immunoassay during the clinical routine of a university veterinary hospital were selected. At admission and every 24 hours until the third day of hospitalization or until death, venous blood samples were collected for complete blood count, renal and hepatic biochemistry, and lactate and magnesium measurement; arterial blood samples were collected for gas analysis. Sodium, potassium, and ionized calcium were also analyzed, and a complete physical examination was performed. The factors associated with mortality were evaluated by Cox univariate analysis at a level of significance of 5%. The increase in urea and heart rate was associated with an increase in the risk of death. In contrast, an increase in total leukocytes, lymphocytes, monocytes, partial pressure of oxygen, base deficit, bicarbonate ion, and oxygen saturation were associated with a reduction in the risk of death.

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Clinical use of plasma lactate concentration. Part 2: Prognostic and diagnostic utility and the clinical management of hyperlactatemia

Abstract: Lactate is a valuable triage and risk stratification tool that can be used to separate patients into higher and lower risk categories. The utility of lactate concentration as a therapeutic target and the measurement of lactate in body fluids shows promise but requires further research.

Cited by 31 publications

References 202 publications

Analysis of Early Assessable Risk Factors for Poor Outcome in Dogs With Cluster Seizures and Status Epilepticus

Analysis of Early Assessable Risk Factors for Poor Outcome in Dogs With Cluster Seizures and Status Epilepticus

Identification and Quantitative Determination of Lactate Using Optical Spectroscopy—Towards a Noninvasive Tool for Early Recognition of Sepsis

Clinical and hematological prognostic factors in dogs with parvoviral enteritis and sepsis

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