Clinical applications of lactate testing in patients with sepsis and septic shock

Ryoo, Seung Mok; Kim, Won Young

doi:10.21037/jeccm.2018.01.13

Cited by 17 publications

(16 citation statements)

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“…These effects might aggravate hypoxic brain injury and produce poor neurological outcomes. Moreover, high-dose adrenergic vasopressors can increase serum lactate by stimulating beta-adrenergic receptors [23]. Cerebral vasoconstriction due to such high-dose vasopressors might influence brain hypoperfusion.…”

Section: Resultsmentioning

confidence: 99%

“…In this study, we hypothesized that the combination of NSE and lactate would be a better predictive factor of neurological outcomes in OHCA patients. As NSE reflects direct neuronal cell damage and lactate is a marker of tissue hypoxia, even in the brain, the combination might accurately predict a poor neurological outcome [18,23]. Thus, we combined the two most predictive factors of each NSEs and lactates, which were the 24 h NSE, 48 h NSE, the initial lactate, and the 24 h lactate.…”

Section: Resultsmentioning

confidence: 99%

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Prognostic Abilities of Serial Neuron-Specific Enolase and Lactate and their Combination in Cardiac Arrest Survivors During Targeted Temperature Management

Ryoo

Sohn

Kim

et al. 2020

JCM

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This study aimed to determine the prognostic ability of serial neuron-specific enolase (NSE) and lactate in cardiac arrest survivors treated with targeted temperature management (TTM) and to investigate whether a combination of NSE and lactate could increase prognostic information. This observational, retrospective, cohort study was conducted between January 2013 and December 2018; data were extracted from an out-of-hospital cardiac arrest registry. We collected serial serum NSE and lactate levels during TTM. The primary endpoint was poor neurological outcome at 28 days from cardiac arrest. Of all 160 included patients, 98 (61.3%) had poor neurological outcomes. Areas under the curves (AUCs) for NSE were 0.797, 0.871, and 0.843 at 24, 48, and 72 h, respectively (all p < 0.05). AUCs for lactate were 0.669, 0.578, 0.634, and 0.620 at 0, 24, 48, and 72 h, respectively (all p < 0.05). Although the combination of initial lactate and NSE at 48 h yielded the highest discovered AUC (0.877) it was not statistically different from that for the 48 h NSE alone (p = 0.692). During the TTM, NSE at 48 h from cardiac arrest was the most robust prognostic marker in comatose cardiac arrest survivors. However, a combination of the 48 h NSE with lactate did not increase the prognostic information.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Prognostic Abilities of Serial Neuron-Specific Enolase and Lactate and their Combination in Cardiac Arrest Survivors During Targeted Temperature Management

Ryoo

Sohn

Kim

et al. 2020

JCM

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“…This increase can be considered a marker of tissue hypoperfusion when found in concentrations ˃1.0 mmol/L (2) . The elevation of plasma lactate results from the production of energy by anaerobic glycolytic (12) , mainly observed in septic shock. Although these two biomarkers show a significant increase in the course of the disease, only lactate is used as a predictor of severity in the clinical practice.…”

Section: Introductionmentioning

confidence: 99%

“…With regard to lactate, as well as NO, the relation between the concentrations of this pathophysiological marker and body temperature in sepsis is little discussed in the literature. In the clinical context, high lactate concentrations serve as a global parameter to identify metabolic impairment in critically ill patients (12,20) .…”

Section: Introductionmentioning

confidence: 99%

Study of thermo-regulation as a worsening marker of experimental sepsis in an animal model

Souza

Batalhão

Cárnio

2020

Rev. Latino-Am. Enfermagem

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Objective: to analyze variations in body temperature and in plasma nitrate and lactate concentrations in rats submitted to the experimental sepsis model. Method: a total of 40 rats divided equally into five groups. The induction of endotoxemia was performed with intravenous administration of lipopolysaccharide, 0.5 mg/Kg, 1.5 mg/Kg, 3.0 mg/Kg, and 10 mg/Kg, respectively. The control group received 0.5 mL of saline solution. The experiment lasted six hours, with evaluations performed at 0 (baseline data), 2nd, 4th, and 6thhours. Results: The animals that received doses up to 3.0 mg/kg showed a significant increase in body temperature compared to the group with 10 mg/kg, which showed a decrease in these values. The increase in plasma nitrate and lactate concentrations in the groups with lipopolysaccharide was significantly higher than in the group that received the saline solution and was correlated with the increase in body temperature. Conclusion: the variations in body temperature observed in this study showed the dose-dependent effect of lipopolysaccharide and were correlated with the increase in the concentrations of nitrate and plasma lactate biomarkers. The implications of this study are the importance of monitoring body temperature, together with the assessment of these pathophysiological markers, which suggest worsening in the prognosis of sepsis.

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“…Sendo aceito que a hiperlactatemia é comum na sepse e no choque séptico e está associada ao mau prognóstico (RYOO; KIM, 2018). No contexto clínico o lactato serve como parâmetro global para avaliar estados de hipoperfusão tecidual em pacientes críticos (JANSEN et al, 2010), já que, o aumento em suas concentrações durante o choque ocorre em função da menor oferta de oxigênio, resultando na hipóxia tecidual e na produção de glicose por via anaeróbia (RYOO; KIM, 2018).…”

Section: N T R O D U ç ã O | 14unclassified

Efeito da endotoxemia na temperatura corporal, pressão arterial média e nas concentrações de nitrato e lactato plasmáticos em ratos

Souza¹

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AGRADECIMENTOSÁ Deus, por conhecer cada detalhe da minha vida e proporcionar condições para que eu pudesse realizar todos os meus sonhos. Obrigado por colocar tantas pessoas boas no meu caminho e permitir com que eu possa seguir em frente. Á todos os amigos e colegas que proporcionaram momentos inesquecíveis no decorrer da vida e que de alguma forma contribuíram para que eu me tornasse a pessoa que sou hoje.Ás minhas orientadoras acadêmicas que me mostraram o caminho para chegar até aqui, obrigado pelo acolhimento, pelo incentivo e pela oportunidade em aprender com vocês, Dra. Evelise Aline Soares, Dra. Denise Holanda Iunes e Dra. Evelin Capellari Cárnio. Á Dra. Evelin Capellari Cárnio pelo exemplo de pessoa, pesquisadora e principalmente pelo Ser Humano que é. Obrigado por tornar essa trajetória leve e repleta de aprendizados.Ao Marcelo Eduardo Batalhão, pelo apoio em todas as etapas deste trabalho, pelas horas de conversa e boas risadas.Aos meus colegas de laboratório Angelita, Felipe, Patrícia e Aline pelos momentos de descontração e aprendizado.Aos meus amigos Juliano Caliari e Bárbara Sousa, obrigado por cada momento vivido até aqui.Ás Faculdades Integradas do Vale do Ribeira, em especial a Deise Aparecida Carminatte por acreditar no meu trabalho e proporcionar condições para a realização desta etapa.Aos meus amigos de Registro-SP Patrícia Santiago e José Simas por estarem presentes nos momentos tristes e felizes.A todos os meus amigos de Alfenas-MG, que mesmo distantes, se fazem presentes na memória e nas oportunidades de encontro. Á Escola de Enfermagem de Ribeirão pela oportunidade de crescimento profissional e possibilidade em cursar o doutorado. RESUMO SOUZA, A. L. T. Efeito da endotoxemia na temperatura corporal, pressão arterial média e nas concentrações de nitrato e lactato plasmáticos em ratos. 2019. 81f. Tese (Doutorado em Ciências) -Escola de Enfermagem de Ribeirão Preto, Universidade de São Paulo, Ribeirão Preto, 2019.Na endotoxemia e na sepse alterações nos sinais vitais e em biomarcadores estão presentes e sinalizam o grau de comprometimento fisiológico. Embora a interpretação sobre as concentrações do óxido nítrico (NO) e do lactato plasmáticos na pressão arterial sejam bem estabelecidas na literatura, elucidações sobre suas participações na temperatura corporal ainda são incipientes. Assim, este estudo teve como objetivo avaliar o efeito da endotoxemia na temperatura corporal, pressão arterial média e correlacionar esses valores com os biomarcadores NO e lactato plasmáticos. Foram utilizados 40 ratos divididos igualmente em cinco grupos experimentais. A indução da endotoxemia foi realizada por meio da administração endovenosa de lipopolissacarídeo (LPS) bacteriano, respectivamente 0,5 mg/Kg, 1,5 mg/Kg, 3,0 mg/Kg e 10 mg/Kg. O grupo controle recebeu 0,5 mL de solução salina. O experimento teve duração de seis horas. Na 0h (medida basal) foram coletadas amostras de sangue (0,4 mL) para dosagem do NO e lactato plasmáticos e obtidos os valores de temperatura corporal e pressão arterial média, na ...

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Clinical applications of lactate testing in patients with sepsis and septic shock

Cited by 17 publications

References 51 publications

Prognostic Abilities of Serial Neuron-Specific Enolase and Lactate and their Combination in Cardiac Arrest Survivors During Targeted Temperature Management

Prognostic Abilities of Serial Neuron-Specific Enolase and Lactate and their Combination in Cardiac Arrest Survivors During Targeted Temperature Management

Study of thermo-regulation as a worsening marker of experimental sepsis in an animal model

Efeito da endotoxemia na temperatura corporal, pressão arterial média e nas concentrações de nitrato e lactato plasmáticos em ratos

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