Serial lactate determinations during circulatory shock

Vincent, Jean‐Louis; Dufaye, Philippe; Berré, Jacques; Leeman, Marc; Degaute, Jean-Paul; Kahn, Robert J.

doi:10.1097/00003246-198306000-00012

Cited by 441 publications

(210 citation statements)

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“…Prior studies in septic shock and tissue hypoperfusion have also established dynamic lactate indices as strongly predictive of mortality-a finding that we now confirm in the intermediate sepsis population (9,(31)(32)(33)(34)(35)(36). Nguyen and colleagues (32) reported an 11% decrease in the odds of hospital death with each 10% increase in lactate improvement in septic shock and hypoperfusion.…”

Section: Discussionsupporting

confidence: 75%

Fluid Volume, Lactate Values, and Mortality in Sepsis Patients with Intermediate Lactate Values

et al. 2013

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Rationale: Patients with severe sepsis without shock or tissue hypoperfusion face substantial mortality; however, treatment guidelines are lacking. Hospital and 30-day mortality were 8.2 and 13.3%, respectively, for patients with lactate clearance; they were 18.7 and 24.7%, respectively, for those without lactate clearance. Each 10% increase in repeat lactate values was associated with a 9.4% (95% confidence interval [CI] = 7.8-11.1%) increase in the odds of hospital death. Within 4 hours, patients received 32 (618) ml/kg of fluid. Each 7.5 ml/kg increase was associated with a 1.3% (95% CI = 0.6-2.1%) decrease in repeat lactate. Across an unrestricted range, increased fluid was not associated with improved mortality. However, when limited to less than 45 ml/kg, additional fluid was associated with a trend toward improved survival (odds ratio = 0.92; 95% CI = 0.82-1.03) that was statistically significant among patients with highly concordant fluid records.Conclusions: Early fluid administration, below 45 ml/kg, was associated with modest improvements in lactate clearance and potential improvements in mortality. Further study is needed to define treatment strategies in this prevalent and morbid group of patients with sepsis.

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Section: Discussionsupporting

confidence: 75%

Fluid Volume, Lactate Values, and Mortality in Sepsis Patients with Intermediate Lactate Values

et al. 2013

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“…The usefulness of both parameters during the early phase of septic shock has been proved, [8][9][10][11] and their measurement forms part of the guidelines in the Surviving Sepsis Campaign. 2 The use of the target diagram facilitated the systematic measurement of these two parameters in our unit; they are now considered essential for the septic patient and are included in the radar chart together with the other usual parameters.…”

Section: Discussionmentioning

confidence: 99%

“…The patients of the target period had significantly more lactate and ScvO 2 measurements than the patients of the control period (average number of measurements, respectively, 2.9 vs 5.5 for lactate and 0.2 vs 5.5 for ScvO 2 ). .62 Necrotizing fascitis (n (%)) 3 (7) 4 (11) .29 Hematological disease n (n (%)) 7 (17) 6 (16) .92 Other (n (%)) 7 (17) 3 (8) .24 Lactate measurements/patient (n (range)) 2.9 (1-6) 5.5 (2-6) .001 ScvO 2 measurements/patient (n (range)) 0.2 (0-2) 5.5 (2-6) <.001 The hemodynamic "target": a visual tool of goal-directed therapy for septic patients Vallée F et al…”

Section: Follow-up and Evaluation Of The Use Of The Target Diagram Bymentioning

confidence: 99%

The Hemodynamic “Target”: A Visual Tool of Goal-Directed Therapy for Septic Patients

Vallée

Fourcade

Marty

et al. 2007

Clinics

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“…19 Vincent et al describe that shock patients with the best prognosis were those in whom lactate levels had considerably decreased within one hour after resuscitation. 20 Husain et al demonstrated that lactate levels in surgical patients on admission and after 24 hours of hospitalization were correlated with mortality. 21 Broder & Weil noted that only 11% of those with serum lactate level greater than 36 mg/ dl survived.…”

Section: Discussionmentioning

confidence: 99%

Lactato sérico como marcador prognóstico em crianças gravemente doentes

Koliski¹,

Cat²,

J³

et al. 2005

J. Pediatr. (Rio J.)

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Objective: To assess the use of lactate as a marker of tissue hypoperfusion and as a prognostic index in critically ill patients.Methods: Prospective, longitudinal, observational study of 75 patients admitted to the pediatric ICU of Hospital de Clínicas of Universidade Federal do Paraná, between November 1998 and May 1999. According to the lactate level on admission, patients were divided into group A (lactate > 18 mg/dl) and group B (lactate < 18 mg/dl). In terms of outcome, patients were classified into survivors and nonsurvivors. In group A, the clinical evaluation and the collection of arterial blood samples were performed on admission, at 6, 12, 24, 48 hours, and every 24 hours after that. In group B, they were carried out in the same way, but interrupted 48 hours after admission.Results: Groups A and B consisted of 50 and 25 patients, respectively. Group A presented more clinical signs of hypoperfusion (24/50). There was a statistically significant difference regarding the mean lactate levels on admission between those patients who died within 24 hours of admission (95 mg/dl) and those who died 24 hours after admission (28 mg/dl). The lactate level at 24 hours of admission revealed better sensitivity (55.6%) and specificity (97.2%) as a predictor of death.Conclusions: Most patients with lactate levels > 18 mg/dl showed clinical signs of hypoperfusion on admission. The normalization or reduction of lactate levels at and after 24 hours of admission was significantly related with higher chances of survival.J Pediatr (Rio J). 2005;81(4):287-92: Blood lactate, lactic acidosis, hyperlactatemia, prognostic index, PICU mortality.

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Serial lactate determinations during circulatory shock

Cited by 441 publications

References 0 publications

Fluid Volume, Lactate Values, and Mortality in Sepsis Patients with Intermediate Lactate Values

Fluid Volume, Lactate Values, and Mortality in Sepsis Patients with Intermediate Lactate Values

The Hemodynamic “Target”: A Visual Tool of Goal-Directed Therapy for Septic Patients

Lactato sérico como marcador prognóstico em crianças gravemente doentes

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