Elevated arterial lactate level as an independent risk factor for pancreatic infection in moderately severe acute pancreatitis

Shu, Wenqing; Wan, Jianhua; Chen, Jie; He, Wenhua; Zhu, Yin; Lü, Nonghua; Xia, Liang

doi:10.1016/j.pan.2019.06.001

Cited by 17 publications

(17 citation statements)

References 25 publications

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“…16 Raised lactate levels has been observed in many critical acute illness situations including sepsis 50 and AP. 51 Elevated lactate may serve as a protective mechanism and has been shown to reduce Toll-like receptor and inflammasome-mediated pancreatic and liver injury via its receptor GPR81. LDH can reversibly catalyze the oxidation of lactate to pyruvate and has been employed by Ranson, Glasgow, Japanese Severity Score, 11 and a nomogram 15 for early AP severity prediction and reported as a simple and useful parameter for predicting POF 52 and pancreatic necrosis.…”

Section: Discussionmentioning

confidence: 99%

Predicting persistent organ failure on admission in patients with acute pancreatitis: development and validation of a mobile nomogram

Shi

Zhang

Zhu

et al. 2022

HPB

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Section: Discussionmentioning

confidence: 99%

Predicting persistent organ failure on admission in patients with acute pancreatitis: development and validation of a mobile nomogram

Shi

Zhang

Zhu

et al. 2022

HPB

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“…According to current research, C-reactive protein (CRP) [19] , procalcitonin (PCT) [20] , changes in serum lactic acid levels [21] , and the product value of serum albumin and prothrombin [22] have all been used as predictors of AP severity. However, the sample size of previous studies was small, or using a single indicator was inaccurate.…”

Section: Discussionmentioning

confidence: 99%

Serum Lactate/Albumin as a Predictor of In-Hospital Mortality in ICU Pancreatitis Patients: an Analysis of the MIMIC-III Database

Bao

Cui

Shen

et al. 2021

Preprint

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Background: Acute pancreatitis (AP) is a common serious illness, and is characterized by rapid deterioration and a high mortality rate. Several biomarkers can evaluate and guide the treatment of acute pancreatitis, but there is currently no consensus on which markers are the most effective, simple, and economical for treating early-onset AP. In this study, we used the MIMIC III database to conduct a retrospective study on the relationship between early lactate/albumin (LAC/ALB), in-hospital mortality, and complication rates in patients with acute pancreatitis in the ICU.Methods: Basic data and indicators of laboratory tests, hospital deaths, and hospitalization days of acute pancreatitis patients were extracted from the database, after which the relationship between LAC/ALB and hospital mortality, ICU hospitalization days, and organ failure were evaluated using a t-test, a rank-sum test, a chi-square test or Fisher's exact probability method, and a Cox proportional hazard model.Results: 894 patients met the requirements and were selected from the MIMIC III database. They were subsequently grouped according to the lower limit ratio of the LAC/ALB normal value of 0.7. The group with LAC/ALB>0.7 showed higher hospital mortality rates, and the Lac, Inr, nitrogen, blood sugar, AKI incidence, Tbil, Sapsii score, and Sofa scores were all higher than the group with LAC/ALB<0.7. A multivariate Cox regression analysis model was used to explore the relationship between LAC/ALB levels and inpatient mortality. After including different adjustment variables, we determined that LAC/ALB is a risk factor for in-hospital death. The results of the subgroup analysis of LAC/ALB levels and mortality of hospitalized patients indicate that higher levels of LAC/ALB are risk factors for in-hospital deaths in patients with acute pancreatitis.

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“…Blood lactic acid can predict pancreatic infection and also was suggested as a goal of fluid resuscitation [ 39 , 40 ]. Blood lactic acid can predict pancreatic infection and even mortality when it is higher than 4 mmol/L [ 41 ].…”

Section: Discussionmentioning

confidence: 99%

Effect of Different‐Volume Fluid Resuscitation on Organ Functions in Severe Acute Pancreatitis and Therapeutic Effect of Poria cocos

et al. 2020

Evidence-Based Complementary and Alternative Medicine

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Objective. To explore the effect of different-volume fluid resuscitation (FR) on organ functions in severe acute pancreatitis (SAP) and to elucidate the therapeutic effect and mechanism of Poria cocos on organ injuries caused by high-volume FR. Methods. 1. Clinical study: retrospective analysis of thirty-one patients about the effect of titrated fluid resuscitation protocol (TFR) on the occurrence of acute kidney injury (AKI) secondary to SAP. 2. Experimental study: rats (N = 30) were randomly divided into five groups: sham, model, low-volume FR (1.5 ml/kg/h), high-volume FR (10 ml/kg/h), and Poria cocos combined with high-volume FR (10 ml/kg/h + intraintestinal administration Poria cocos 5 g/kg); serum or plasma indicators and histopathologic scores were compared to explore the effect and mechanism of different fluid volumes and Poria cocos on organ function in SAP. Results. The occurrence of AKI, fluid volume, and fluid velocity in TFR group was lower than that in the control group. Logistic regression analysis showed that increased Marshall scores and fluid velocity were risk factors for predicting occurrence of AKI in SAP. Low-volume FR decreased the levels of blood urea nitrogen (BUN), serum creatinine (Cr), matrix metalloproteinase (MMP), and pathologic scores of the pancreas and kidney. High-volume FR increased ascites, MMPs, and kidney pathologic scores. Poria cocos decreased the levels of BUN, Cr, MMPs, and pathologic scores of the pancreas and kidney and increased the arterial oxygen saturation. Conclusion. TFR-associated lower fluid volume and velocity reduced the occurrence of AKI secondary to SAP. High volume might aggravate AKI via increased MMP release leading to endothelial glycocalyx damage and vascular endothelial dysfunction. Poria cocos reduced MMP release, relieved glycocalyx damage, and alleviated the pancreas and kidney injury aggravated by high fluid volume in SAP. Therefore, endothelial glycocalyx protection might be a new strategy in the treatment of SAP.

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Elevated arterial lactate level as an independent risk factor for pancreatic infection in moderately severe acute pancreatitis

Cited by 17 publications

References 25 publications

Predicting persistent organ failure on admission in patients with acute pancreatitis: development and validation of a mobile nomogram

Predicting persistent organ failure on admission in patients with acute pancreatitis: development and validation of a mobile nomogram

Serum Lactate/Albumin as a Predictor of In-Hospital Mortality in ICU Pancreatitis Patients: an Analysis of the MIMIC-III Database

Effect of Different‐Volume Fluid Resuscitation on Organ Functions in Severe Acute Pancreatitis and Therapeutic Effect of Poria cocos

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