Effective lactate clearance is associated with improved outcome in post-cardiac arrest patients

Post–Cardiac Arrest Syndrome

“…This limits the usefulness of a single measurement during early hemodynamic optimization. Lactate clearance has been associated with outcome in patients with ROSC after out-of-hospital cardiac arrest 140,141 ; however, lactate clearance can be impaired by convulsive seizures, excessive motor activity, hepatic insufficiency, and hypothermia.…”

Investigation of biomarker variations post-return of spontaneous circulation following an out-of-hospital cardiac arrest

“…In post-cardiac arrest patients, lactic acidosis may occur due to increased lactate production as a consequence of microcirculatory and mitochondrial dysfunction leading to inadequate tissue perfusion and oxygen supply or decreased lactate clearance [11,19]. In a retrospective study including 128 patients with ROSC following OHCA, it was shown that mortality increased in parallel with serum lactate levels collected within one hour from ROSC, from 39% in those with a lactate level <5 mmol/L to 92% in those with lactate level ≥10 mmol/L [11].…”

Lactate Clearance is a Prognostic Factor in Patients on Shock State

“…We consider that lactate clearance determination may be a better prognostic factor of organic failure and mortality, because patients with high lactate clearance have less mortality rate than those with low lactate clearance. The best lactate clearance rate is correlated as well with decreased in some biomarker such as interleukins 1,6,8,10, tumor necrosis factor alpha, caspase 3. On the other hand, some studies have demonstrated that normal lactate rates can be found on cardiogenic shock, acute renal failure, and that lactate clearance are altered on these, probably because of multiorgan failure (9,(10)(11)(12)(13)(14)(15)(16).…”

“…Elevated seric lactate concentrations are found in hepatic cirrhosis, renal failure, diabetes mellitus, cancer, convulsions, cholera, acute pancreatitis and use of pharmaceutics (biguanides, isoniazide, nitroprusiate, ethanol, salicylates, lactulose, etc.) for that, these conditions may alter prognostic value interpretation of the hyperlactacidemia in shock patients (6,9,10). We consider that lactate clearance determination may be a better prognostic factor of organic failure and mortality, because patients with high lactate clearance have less mortality rate than those with low lactate clearance.…”