2012
DOI: 10.1177/2048872612451168
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Lactate and lactate clearance in acute cardiac care patients

Abstract: Hyperlactataemia is commonly used as a diagnostic and prognostic tool in intensive care settings. Recent studies documented that serial lactate measurements over time (or lactate clearance), may be clinically more reliable than lactate absolute value for risk stratification in different pathological conditions. While the negative prognostic role of hyperlactataemia in several critical ill diseases (such as sepsis and trauma) is well established, data in patients with acute cardiac conditions (i.e. acute corona… Show more

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Cited by 66 publications
(51 citation statements)
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“…This metabolic rearrangement, known as the Pasteur effect, represents the major adaptive mechanism to survive hypoxia. 27,28 The significant correlation we found between WIT and lactate values measured before nRP start may confirm previous data on cardiac arrest 29,30 and the strict link between hypoperfusion and hyperlactatemia. On the other hand, the lack of changes in lactate values during nRP is more difficult to interpret.…”
Section: Discussionsupporting
confidence: 87%
“…This metabolic rearrangement, known as the Pasteur effect, represents the major adaptive mechanism to survive hypoxia. 27,28 The significant correlation we found between WIT and lactate values measured before nRP start may confirm previous data on cardiac arrest 29,30 and the strict link between hypoperfusion and hyperlactatemia. On the other hand, the lack of changes in lactate values during nRP is more difficult to interpret.…”
Section: Discussionsupporting
confidence: 87%
“…While the prognostic role of hyperlactatemia in several critical ill diseases (such as sepsis and trauma) is well established, data in patients with acute cardiac conditions (i.e., acute coronary syndromes) are scarce and controversial. Blood lactate concentration obtained on emergency department on arrival may identify patients with critical cardiac illness (e.g., acute myocardial infarction), severe congestive heart failure, serious arrhythmias, and cardiogenic shock and correlates with a poor short-term outcome after AMI and cardiac surgery [13]. Lazzeri et al [14], in the regression analysis, also proved that lactate levels were an independent predictor for intraintensive cardiac care unit mortality in patients with insulin resistance.…”
Section: Discussionmentioning
confidence: 99%
“…The three most widely used prediction models in the Intensive Care Unit (ICU); the Acute Physiology and Chronic Health Evaluation (APACHE), Mortality Probability Model (MPM) and the Simplified Acute Physiology Score (SAPS) were initially developed more than 30 years ago and have been updated several times since, in order to improve the mortality prediction after ICU admission . Although there is ample evidence for lactate concentration being a strong predictor of mortality and the fact that it is routinely measured in many ICUs, none of these three models include lactate levels in their algorithms.…”
mentioning
confidence: 99%