Myocardial lactate deprivation is associated with decreased cardiovascular performance, decreased myocardial energetics, and early death in endotoxic shock

Lévy, Bruno; Mansart, Arnauld; Montemont, Chantal; Gibot, Sébastien; Mallié, Jean-Pierre; Régnault, V.; Lecompte, Thomas; Lacolley, Patrick

doi:10.1007/s00134-006-0523-9

Cited by 87 publications

(60 citation statements)

References 33 publications

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“…Moreover, the CI was slightly higher in the group receiving lactate as has already been observed [19]. It is known that lactate improves cardiac efficiency during shock [32,33], and it has been shown that lactate deprivation during shock impairs heart metabolism [34]. Despite the fact that hypertonic fluids contained the same amounts of sodium, HSB and HSL were different in term of calories.…”

Section: Discussionsupporting

confidence: 54%

Hypertonic sodium lactate improves fluid balance and hemodynamics in porcine endotoxic shock

Duburcq¹,

Favory²,

Mathieu³

et al. 2014

Critical Care

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Section: Discussionsupporting

confidence: 54%

Hypertonic sodium lactate improves fluid balance and hemodynamics in porcine endotoxic shock

Duburcq¹,

Favory²,

Mathieu³

et al. 2014

Critical Care

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“…The high efficacy of our citrate protocol and excellent patient homeostatic stability support the idea that lactate buffer is well tolerated in citrate CRRT. Lactate buffers are still widely used due to lack of evidence in favor of bicarbonate-buffered solutions, growing interest in providing lactate as an outstanding metabolic substrate under stress conditions [11,22,23], solution stability and lower cost compared to bicarbonate solutions [7]. …”

Section: Discussionmentioning

confidence: 99%

Quantification of Systemic Delivery of Substrates for Intermediate Metabolism during Citrate Anticoagulation of Continuous Renal Replacement Therapy

et al. 2011

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Background: There are limited data on systemic delivery of metabolic substrates during citrate anticoagulation. The direct citrate measurements are usually not available. Methods: Patients on 2.2% acid-citrate-dextrose (ACD, n = 41) were compared to a control group on unfractionated heparin (n = 17). All were treated on 1.9-m² polysulfone filters. Samples were taken from the central venous catheter, ports pre- and post-filter and from effluent. Results: The gain of citrate in CVVH (n = 18) was not different from CVVHDF (n = 23, p = 0.8). Mean gain of citrate was 25.4 ± 6.4 mmol/h. The systemic loads of lactate (p = 0.12) and glucose (p = 0.23) in CVVH were similar to CVVHDF. Mean inputs of lactate and glucose were 62.9 ± 21.1 and 26.6 ± 10.4 mmol/h, respectively. The mean difference between post- and prefilter unmeasured anions (d-UA) correlated with mean difference of citrate concentrations (p < 0.0001, r² = 0.66). The estimated caloric load of the citrate modalities was 5,536 ± 1,385 kJ/ 24 h. Conclusions: ACD might represent a significant load of metabolic substrates, particularly if used with lactate buffer. Systemic delivery of citrate can be predicted using d-UA in the extracorporeal circuit.

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“…Adenosine triphosphate (ATP), adenosine diphosphate (ADP), and adenosine monophosphate (AMP) were simultaneously detected by a fluorescence detector. 20 In addition, the total adenine nucleotide pool (total adenine nucleotide pool ϭ ATP ϩ ADP ϩ AMP), the ATP/ADP ratio, and the total energy charge (total energy charge ϭ (ATP ϩ 0.5 ADP)/(ATP ϩ ADP ϩ AMP)) were also calculated from the above data.…”

Section: Tissue Adenine Nucleotide and Lactate Measurementsmentioning

confidence: 99%

Comparison of Equipressor Doses of Norepinephrine, Epinephrine, and Phenylephrine on Septic Myocardial Dysfunction

et al. 2012

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Background: Myocardial depression is a frequent event during septic shock and may mimic a cardiogenic shock state with decreased cardiac output. Nevertheless, data are scarce regarding the myocardial effects of vasopressors used to treat hypotension. In this study, the authors compared the effects of three commonly used vasopressors acting on different adrenergic receptors on myocardial function in a rodent model of septic shock, as explored with conductance catheter and positron emission tomography. Methods: Septic shock was induced in rats by peritonitis. Eighteen hours after septic insult, vasopressors were titrated to increase mean arterial pressure by 20% compared with baseline values. Results: We observed that peritonitis was associated with arterial hypotension and systolodiastolic dysfunction. Norepinephrine and epinephrine improved mean arterial pressure, cardiac output, and preload recruitable stroke work, a load-independent measure of systolic function, as well as diastolic function and ventriculoarterial coupling. Heart rate, myocardial oxygen consumption, and arrhythmia incidence were furthermore increased in the epinephrine group. Conversely, phenylephrine, a peripheral ␣-agonist, exhibited

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Myocardial lactate deprivation is associated with decreased cardiovascular performance, decreased myocardial energetics, and early death in endotoxic shock

Abstract: Systemic lactate deprivation is detrimental to myocardial energetics, cardiovascular performance, and outcome.

Cited by 87 publications

References 33 publications

Hypertonic sodium lactate improves fluid balance and hemodynamics in porcine endotoxic shock

Hypertonic sodium lactate improves fluid balance and hemodynamics in porcine endotoxic shock

Quantification of Systemic Delivery of Substrates for Intermediate Metabolism during Citrate Anticoagulation of Continuous Renal Replacement Therapy

Comparison of Equipressor Doses of Norepinephrine, Epinephrine, and Phenylephrine on Septic Myocardial Dysfunction

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