Persistent Occult Hypoperfusion Is Associated with a Significant Increase in Infection Rate and Mortality in Major Trauma Patients

Claridge, Jeffrey A.; Crabtree, Traves D.; Pelletier, Shawn J.; Butler, Kathy; Sawyer, Robert G.; Young, Jeffrey S.

doi:10.1097/00005373-200001000-00003

Cited by 206 publications

(133 citation statements)

References 37 publications

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“…There was a significant relation between mean age and mortality (p=0.008). Mean (6)(7)(8)(9)(10)(11)(12)(13)(14)(15)(16)(17)(18)(19)(20)(21)(22)(23)(24) hours in the HL group. There was a significant relation between increased MVD and mortality (p=0.006).…”

Section: Resultsmentioning

confidence: 99%

The Relationship of Hyperlactatemia Following Paediatric Open Heart Surgery with Mortality, Morbidity and Risk Factors

Oğuz¹,

Bozoglan²,

Serhatlıoğlu³

et al. 2014

Erciyes Med J

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Objective: In this present study, the association of hyperlactatemia frequency with probable risk factors, postoperative morbidity and mortality were investigated in patients undergoing paediatric open heart surgery. Materials and Methods:The present study included 45 consecutive paediatric patients who had undergone open heart surgery with hypothermic cardiopulmonary bypass in the cardiovascular surgery clinic between January 2008 and July 2008. Four blood samples for lactate analysis were collected from each of the patients preoperatively, intraoperatively and at 1 and 12 hours postoperatively. The patients were divided into two groups according to blood lactate levels as the high lactate group (mean lactate level≥ 3 mmol/L) and the normal lactate group (mean lactate level <3 mmol/L). Hyperlactatemia frequency, associated risk factors, and the relationship with morbidity and mortality were statistically analysed.Results: Of 45 cases, 33 (73.3%) were included in the normal lactate (NL) group, and 12 (26.7%) were included in the high lactate (HL) group. A borderline association was found between lactate levels and mortality in the HL group (p=0.052). Body surface area, age, low cardiac output syndrome, intraoperative and postoperative inotropic support requirement, duration of mechanical ventilation were determined as risk factors associated with mortality (p<0.05), and low cardiac output syndrome, urine output and metabolic acidosis were determined as risk factors associated with hyperlactatemia (p<0.05). Conclusion:In patients followed up in the intensive care unit, lactate concentration is a good indicator for disease severity. Blood lactate levels seems to be a parameter that can be used in routine follow-up.

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Section: Resultsmentioning

confidence: 99%

The Relationship of Hyperlactatemia Following Paediatric Open Heart Surgery with Mortality, Morbidity and Risk Factors

Oğuz¹,

Bozoglan²,

Serhatlıoğlu³

et al. 2014

Erciyes Med J

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show abstract

“…Similar to our study, Shapiro et al [8] with 1278 patients demonstrated that increasing lactate levels were associated with increased mortality in the patients presenting with sepsis. Sustained high lactate levels in ICU patients demonstrated by serial measurements have shown to be predictive of in hospital mortality [9][10][11] Nichol AD et al in their study concluded that In critically ill patients, relative hyperlactataemia is independently associated with increased hospital mortality. Blood lactate concentrations > 0.75 mmol.L-1 can be used by clinicians to identify patients at higher risk of death.…”

Section: Discussionmentioning

confidence: 99%

Lactate Levels As A Prognostic Indicator In Heterogeneous ICU Population

Ommid¹,

Khatoom

Ishaq

et al. 2017

AAMS

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Background:The period course of blood lactate levels could be supportive to evaluate a patient's response to therapy. Serial blood lactate levels in different groups of acutely ill patients. Methods:A total of 200 patients admitted to ICU with critical illness were randomly selected for the study group, Relevant demographic information, clinical history, clinical and laboratory parameters including diagnosis and length of ICU stay were recorded from each patient. The first sample was taken on admission the other samples was taken on 2nd, 3rd and 4th day of admission. Serial arterial sample lactate measurement was done from the patients to note the initial level, time of maximal level and level at time to normal. Result:In the study population 27.5% belonged to the age group of 40-49 years followed by 24% in the age group 50-59 and 20.5% in 60-69 yrs. 57% patients were males and 43% were females. 20.5% patients expired 34.5% patients had hyperlactatemia during ICU stay out of which 31.9% patients expired. Conclusion:Elevated lactate is encountered in a multitude of clinical presentations. Hyperlactatemia is associated with an in-hospital mortality in a heterogeneous ICU population. Patients with elevated lactate levels predicted in hospital mortality and also normalization of lactate within 6 hours is associated with lower mortality. The observation of a better outcome associated with decreasing blood lactate concentrations was consistent throughout the clinical study. Lactate level is an easily measured laboratory parameter which can provide useful information for the bedside clinician when incorporated into the apt clinical milieu.

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“…Persistent hyperlactatemia is considered to reflect occult hypoperfusion and has been associated with poor outcomes in trauma [32], cardiac arrest [33] and high-risk surgery [34].…”

Section: Lactate Clearancementioning

confidence: 99%

Haemodynamic Monitoring in the Intensive Care Unit

Majumdar¹

2017

Intensive Care

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Monitoring is a cognitive aid that allows clinicians to detect the nature and extent of pathology and helps assessment of response to therapy. The cardiovascular system is the most commonly monitored organ system in the critical care setting. It helps identify the presence and nature of shock and guides response to resuscitation by detection of cardiac rate and rhythm, evaluation of volume state, cardiac contractility and systemic vascular resistance. Newer technologies allow greater assessment of oxygen delivery to vulnerable tissues. We discuss the nature, history, modalities and interpretation of the most commonly available haemodynamic monitoring methods in clinical use currently.

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Persistent Occult Hypoperfusion Is Associated with a Significant Increase in Infection Rate and Mortality in Major Trauma Patients

Abstract: A clear increase in infections occurred in patients with OH whose lactate levels did not correct by 12 hours, with an associated increase in length of stay, days in surgical/trauma intensive care unit, hospital charges, and mortality.

Cited by 206 publications

References 37 publications

The Relationship of Hyperlactatemia Following Paediatric Open Heart Surgery with Mortality, Morbidity and Risk Factors

The Relationship of Hyperlactatemia Following Paediatric Open Heart Surgery with Mortality, Morbidity and Risk Factors

Lactate Levels As A Prognostic Indicator In Heterogeneous ICU Population

Haemodynamic Monitoring in the Intensive Care Unit

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