Serum Lactate as Serum Biomarker for Cardiopulmonary Parameters within the First 24 Hours after a Spontaneous Intracerebral Hemorrhage

Abstract

Objective: Cardiopulmonary (CP) complications are well known in patients with an intracerebral hemorrhage (ICH) and could be associated with a higher serum lactate level. The present study aimed to assess the associations between the initial serum lactate level and the CP parameters within the first 24 h of intensive care unit (ICU) treatment in neurosurgical ICH patients. Patients and Methods: A total of 354 patients admitted to the ICU between 01/2009 and 12/2017 with a diagnosis of an ICH were retrospectively analyzed. Blood samples were taken upon admission, and each patient’s demographic, medical, and radiological data upon admission, as well as several CP parameters, were recorded within the first 24 h of ICU treatment. Results: A higher serum lactate level was associated with a lower GCS score (p < 0.0001), as well as a higher Acute Physiology and Chronic Health Evaluation II score (p = 0.002) upon admission. Additionally, patients with initially higher serum lactate levels had a significantly higher need for a norepinephrine application (p = 0.004) and inspiratory oxygen fraction (p = 0.03) within the first 24 h. Conclusion: Neurosurgical ICH patients with higher serum lactate levels upon admission require more CP support within the first 24 h of ICU treatment.

Clinical significance of serum lactate and lactate dehydrogenase levels for disease severity and clinical outcomes in patients with colorectal cancer admitted to the intensive care unit

“…Therefore, when assessing the disease severity and predicting clinical outcomes in patients with CRC requiring ICU admission, it might be more useful to consider serum LA levels instead of serum LDH. Previous studies have highlighted that serum LA levels are commonly used as a biomarker in ICUs to assess disease severity and predict outcomes in various conditions, including sepsis, septic shock, cardiac arrest, trauma, local ischemia, and liver dysfunction [ 40 ]. One possible explanation is that, in the case of patients with CRC admitted to the ICU, the detrimental effects of severe complications and impaired circulatory organ function may outweigh the impact of the tumor itself.…”

Association of lactate-to-albumin ratio with in-hospital and intensive care unit mortality in patients with intracerebral hemorrhage

“…First, ICH usually triggers a stress response in the body, which can lead to a disorder in the internal environment. Patients with ICH experience microcirculatory dysfunction and hypermetabolic conditions that lead to lactate accumulation in the brain (39)(40)(41)(42). ICH induces an acute inflammatory response due to reduced hepatic synthesis of albumin and increases the endothelial permeability of albumin from the vasculature into the extravascular space, decreasing serum albumin concentration (43)(44)(45).…”

Serum Urea-to-Albumin Ratio Is an Independent Predictor of Intra-Hospital Mortality in Neurosurgical Intensive Care Unit Patients with Spontaneous Intracerebral Hemorrhage

“…Currently, a larger volume and expansion of ICH, lower level of consciousness, lower Glasgow Coma Scale (GCS) score, advanced age, larger peri-hemorrhagic edema, and the presence of an intraventricular hemorrhage (IVH) and hydrocephalus are the most frequently used early predictors for mortality and poor outcome in ICH patients [8][9][10][11][12][13]. In addition to these well-known predictors, several studies have demonstrated the benefit of serum biomarkers, e.g., elevated levels of C-reactive protein (CRP), troponin I, cortisol, blood glucose, serum lactate, and white blood cell count, as well as CRP-to-albumin and fibrinogen-to-albumin ratios, to predict poor outcome and increased mortality in ICH patients [6,[14][15][16][17][18][19][20].…”