Lactate and lactate clearance in critically burned patients: usefulness and limitations as a resuscitation guide and as a prognostic factor

Lucas, E. Herrero de; Sánchez-Sánchez, Manuel; Fuciños, L. Cachafeiro; Rotaeche, A. Agrifoglio; Méndez, José Ramón Martínez; Cabeza, E. Flores; Estañ, P. Millán; Garcı́a-de-Lorenzo, Abelardo

doi:10.1016/j.burns.2020.06.003

Cited by 12 publications

(8 citation statements)

References 27 publications

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“…At present, there are few other simple and easily available biomarkers that can predict the prognosis of severe burns. A recent study ( 38 ) found that initial elevated lactate levels were a factor of poor prognosis of severe burns, however, the global clearance of lactate in the first 24 h, unlike what occurred in other injuries, did not correlate with mortality. Ding X B et al ( 39 ) found that the ROC-AUC of serum lactate at 48 h post-admission to predict death of 127 patients was 0.811, which was very close to the ROC-AUC of PPR (0.816) on day 3 in our study.…”

Section: Discussionmentioning

confidence: 93%

Prognostic Values of Platelet Distribution Width and Platelet Distribution Width-to-Platelet Ratio in Severe Burns

Lin

Zheng

et al. 2021

Shock

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Background: Platelet distribution width (PDW) and PDW-to-platelet ratio (PPR) have been proven to be good prognostic indicators for many diseases. However, their prognostic values in severe burns have not been reported. Objective: To investigate the early time course of PDW and PPR in severe burn patients and investigate their prognostic values. Methods: This is a 16-year, single-center retrospective study of 590 severe burn patients. The complete blood count parameters on day 1, day 3, and day 7 postburn, including PDW and PPR, were collected. Receiver operating characteristic curves (ROC) analysis, multiple logistic regression analysis and Kaplan-Meier survival analysis were performed to evaluate the prognostic values of PDW and PPR in severe burn patients. Results: According to 120-day follow-up records, 96 patients were nonsurvivors and 494 patients were survivors. ROC and area under the curve (AUC) analysis showed that, for predicting 120-day prognosis, the AUC of PDW (0.782) and PPR (0.816) on day 3 was the highest, followed by the AUC of PDW (0.764) and PPR (0.750) on day 7. The ROC-AUC of PPR (0.816) on day 3 was very close to that of the ABSI score (0.818). Multiple logistic regression analysis showed that the PDW (P ¼ 0.033 and P ¼ 0.009) and PPR (P ¼ 0.052 and P ¼ 0.046) on day 3 and day 7 were all significantly independently positively associated with 120-day mortality. Kaplan-Meier survival analysis showed that high PDW and PPR were both significantly associated with a high 120-day mortality rate on day 3 and day 7. Conclusion: PDW and PPR on day 3 and day 7 were independent risk factors for 120-day mortality in severe burn patients. These objective and readily available prognostic indicators may be more clinically favored.

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Section: Discussionmentioning

confidence: 93%

Prognostic Values of Platelet Distribution Width and Platelet Distribution Width-to-Platelet Ratio in Severe Burns

Lin

Zheng

et al. 2021

Shock

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“…The study did not analyze the lactate initial concentration which was widely used in previous studies [ 15 , 20 , 21 ]. It is because the course of illness and the occasion of the individuals' admission to the ICU is different, and the collection time of the initial lactate concentration is also different.…”

Section: Discussionmentioning

confidence: 99%

“…Several studies have confirmed that persistent hyperlactatemia is related to an increased risk of ICU admission and higher mortality [ 4 , 13 , 14 ]. A series of studies have emphasized the prognostic value of LC, but LC cannot suggest the severity of hyperlactatemia [ 9 , 15 , 16 ]. The lactate area is defined as the sum of the area under the curve of serum lactate levels, as it is an index demonstrating the duration and severity of hyperlactatemia [ 9 , 15 , 16 ].…”

Section: Introductionmentioning

confidence: 99%

Evaluation of plasma lactate parameters for predicting mortality of septic patients

Wang¹,

Wang²,

Liu³

et al. 2022

Heliyon

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“…The results show that elevations in initially obtained serum lactate levels are strong predictors of mortality in critically ill patients and identifying patients whose serum lactate levels are more likely to increase can alert physicians to improve care and guide them in determining the frequency of conducting blood tests [24]. Therefore, lactate levels are considered a valuable indicator of patient mortality and can be used to guide treatment [25][26][27].…”

Section: Introductionmentioning

confidence: 96%

The combination of lactate level, lactate clearance and APACHE II score better predicts short-term outcomes in critically Ill patients: a retrospective cohort study

et al. 2022

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Background The mortality rate is high in critically ill patients due to the difficulty of diagnosis and treatment. Thus, it is very important to explore the predictive value of different indicators related to prognosis in critically ill patients. Methods This was a retrospective cohort study of patients in the intensive care unit (ICU) of the Sixth People’s Hospital in Shanghai, China. A total of 1465 ICU patients had lactate values > 2.1 mmol/L at least once within 24 h of ICU admission, and arterial blood gas was monitored more than twice during the ICU stay. Results The predictive value of lactate clearance at 24 h was not high, and the sensitivity and specificity were lower. The predictive value of the lactate level at baseline and the APACHE II score was higher than that of lactate clearance at 24 h in critically ill patients. The predictive value of the lactate level at baseline combined with the APACHE II score was higher than that of the lactate level at baseline or the APACHE II score alone. In addition, the predictive value of lactate clearance at 24 h combined with the APACHE II score was also significantly higher than that of lactate clearance at 24 h or the APACHE II score alone. In particular, the area under the ROC curve reached 0.900, the predictive value was markedly higher than that of the ROC alone, and the sensitivity and specificity were better when these three indicators were combined. Conclusions The combination of lactate level, lactate clearance and APACHE II score better predicts short-term outcomes in critically ill patients.

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Lactate and lactate clearance in critically burned patients: usefulness and limitations as a resuscitation guide and as a prognostic factor

Cited by 12 publications

References 27 publications

Prognostic Values of Platelet Distribution Width and Platelet Distribution Width-to-Platelet Ratio in Severe Burns

Prognostic Values of Platelet Distribution Width and Platelet Distribution Width-to-Platelet Ratio in Severe Burns

Evaluation of plasma lactate parameters for predicting mortality of septic patients

The combination of lactate level, lactate clearance and APACHE II score better predicts short-term outcomes in critically Ill patients: a retrospective cohort study

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