Appropriate Clinical Use of Lactate Measurements

Pino, Richard M.; Singh, Jaskaran

doi:10.1097/aln.0000000000003655

Cited by 33 publications

(26 citation statements)

References 64 publications

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“…Serum lactate has several limitations such as being elevated in several aerobic conditions (liver impairment, infections, and convulsions); and having slow dynamics. 13 Hernandez et al had found that 50% of the survivors of septic shock had persistently elevated lactate 24 h after resuscitation. 14 Thus, the use of a combined index was hypothesized to provide a more comprehensive marker than the use of either marker alone.…”

Section: Discussionmentioning

confidence: 99%

The Use of Lactate-Capillary Refill Time Product as Novel Index for Tissue Perfusion in Patients with Abdominal Sepsis: A Prospective Observational Study

Shaker¹,

Hasanin²,

Nagy³

et al. 2022

IJGM

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Section: Discussionmentioning

confidence: 99%

The Use of Lactate-Capillary Refill Time Product as Novel Index for Tissue Perfusion in Patients with Abdominal Sepsis: A Prospective Observational Study

Shaker¹,

Hasanin²,

Nagy³

et al. 2022

IJGM

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“…The Third International Consensus Definitions for Sepsis and Septic Shock showed that elevated lactate levels are reflective of cellular dysfunction in sepsis [ 17 ]. Basic studies have shown that even if the body has no hypoxia, if mitochondrial function is damaged and the tissue cannot uptake oxygen normally, the lactic acid value will increase [ 18 ]. Obvious blood volume declines in the early period is characteristic of acute pancreatitis, hyperfusion causes organ dysfunction and reperfusion injury can exacerbate the severity of pancreatitis.…”

Section: Discussionmentioning

confidence: 99%

Prognostic Value of Arterial Lactate Metabolic Clearance Rate in Moderate and Severe Acute Pancreatitis

Zeng

Wan

et al. 2022

Disease Markers

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Purpose. High lactate levels at hospital admission are significantly associated with poor prognosis in acute pancreatitis patients. Early high lactate clearance is a vital marker for predicting persistent organ failure and mortality in critical illness; however, its value in acute pancreatitis remains unclear. Method. Data were collected from patients who were diagnosed with moderately severe acute pancreatitis and severe acute pancreatitis from January 2017 to December 2020. Initial lactate (within 2 hours after admission) and repeat lactate at 24 hours after admission were measured to determine lactate clearance. Low clearance was defined as a reduction in repeat lactate of less than 30% compared to the first measurement. High clearance was defined as a repeat lactate decrease ≥30% of the first measurement or both first and second lactate levels <2 mmol/L. Baseline data, laboratory data, mortality rate, persistent organ failure rate, and other outcomes such as the incidence of septic pancreatic necrosis and sepsis and the length of hospital stay and intensive care unit (ICU) stay were compared in the low and high lactate clearance groups. Multivariate logistic regression analyses were used to assess the value of lactate clearance for predicting death. Result. Among 4425 acute pancreatitis patients, 3040 patients were diagnosed with moderate or severe acute pancreatitis, and 1028 patients had initial lactate measured. Finally, 390 patients who had initial and 24-hour repeat lactate data were included in the study. Patients who had elevated initial lactate had poor outcomes, and 51 patients in the initial elevated lactate group died. In the lactate normalization group analysis, 293 patients had 24-hour lactate normalization; compared with patients in the nonnormalization group, they had a lower rate of mortality (12.6% vs. 33%). In the lactate clearance group analysis, 70 (21.9%) patients had a low clearance after 24 hours; compared with patients in the high clearance group, they had a higher rate of developing persistent multiorgan failure ( P = 0.045 ), and the incidence of death was higher (15% vs. 28.6%, P = 0.007 ). Multivariate logistic analysis showed that 24-hour lactate clearance (OR: 2.007; 95% CI:1.032-3.903, P = 0.04 ), elevated initial lactate (OR: 2.011; 95% CI:1.023-3.953, P = 0.043 ), blood urea nitrogen (OR: 2.316; 95% CI:1.061-5.056, P = 0.035 ), and white blood count (OR: 1.982; 95% CI:1.026-3.829, P = 0.042 ) were independent predictors of hospital mortality. Conclusion. The 24-hour clearance of lactate is a reliable marker to predict the outcome of moderate and severe acute pancreatitis, and low lactate clearance may indicate that the patient’s condition will worsen, requiring aggressive treatments to improve patient outcomes.

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“…Cerrahi sürenin uzun olması, doku hipoperfüzyonuna bağlı laktat artışı ve metabolik asidozun nedenlerindendir. Laktat artışı yetersiz doku perfüzyonunun önemli bir göstergesidir (16,27). Ongun ve ark.…”

Section: Metabolik Sorunlarunclassified

“…Perioperatif dönemde hiperglisemi de gözlenebilir. Hipergliseminin ateş, enfeksiyon, kan transfüzyonu, hipotermi gibi faktörlere bağlı olmadığının belirlenmesi gerekir (27). Bununla beraber hipergliseminin, mekanik ventilasyonda kalış süresi, yoğun bakımda ve hastanede kalış sürelerini uzatmadığı gösterilmiştir (28).…”

Section: Metabolik Sorunlarunclassified

Anesthesia Management for Craniosynostosis Surgery

Özlü¹

2022

JARSS

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Craniosynostosis is premature fusion of one or more cranial sutures. In isolated craniosynostosis, surgical procedures are applied to ensure normal brain development and normal cognitive functions, to correct cosmetic deformities in order to prevent psychosocial negative consequences. The fact that they are mostly infants, combined with significant blood loss in the perioperative period, makes these cases challenging for the anesthetist. Ensuring airway safety, coping with metabolic complications related to blood transfusions and infusion of electrolyte fluids, preventing hypothermia, postoperative pain management, treatment of nausea and vomiting are the main subjects of anesthesia management. Excellent results can be obtained with proper preoperative planning, monitoring and timely blood and fluid infusion. Keywords: Craniosynostosis, anesthesia, neurosurgery

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Appropriate Clinical Use of Lactate Measurements

Abstract: Elevated lactate can result from many pathophysiologic processes. Understanding the mechanism of lactate production, metabolism, and the basics of lactic acidosis will enable the appropriate use of laboratory tests and interpretation.

Cited by 33 publications

References 64 publications

The Use of Lactate-Capillary Refill Time Product as Novel Index for Tissue Perfusion in Patients with Abdominal Sepsis: A Prospective Observational Study

The Use of Lactate-Capillary Refill Time Product as Novel Index for Tissue Perfusion in Patients with Abdominal Sepsis: A Prospective Observational Study

Prognostic Value of Arterial Lactate Metabolic Clearance Rate in Moderate and Severe Acute Pancreatitis

Anesthesia Management for Craniosynostosis Surgery

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