Blood lactate and lactate kinetics as treatment and prognosis markers for tissue hypoperfusion. Issue 1 (2nd January 2020)

• Record Type: Journal Article
• Authors: Verhaeghe, Marzia; Hachimi-Idrissi, Saïd
• Is Part Of: Acta clinica belgica. Volume 75:Issue 1(2020)
• Page Start: 1
• Page End: 8
• Publication Date: 2020-01-02
• Subjects: Hypovolemic shock -- cardiogenic shock -- septic shock -- lactic acid -- lactate kinetics; Clinical medicine -- Periodicals; Diagnosis, Laboratory -- Periodicals; 616.005
• DOI: 10.1080/17843286.2018.1560612
• Languages: English
• ISSNs: 1784-3286

Abstract

ABSTRACT: Objective : Blood lactate concentration (L) and lactate kinetic (LK) over time might be a helpful marker of the shock severity. The purpose of this study is to analyze whether the L and LK could correlate with the outcome and the therapy of patients with different types of shock. Methods : Design : A 3.5-year retrospective observational study. Patients : Eighteen years of age or older, diagnosed with shock were included. Arterial L measurements were performed upon admission and approximatively 3 and 6 h later. The evolution of lactate over this period of time was correlated with the outcome and therapy. Interventions : Univariate and multivariable statistical tests were performed to examine the relation between the initial L/LK and the in-hospital mortality, total mortality, length of stay (LOS), the LOS at the intensive care unit and the administered therapy. The optimal cut-off point of the LK over time to predict the mortality was calculated. Results : The initial L and the 6 h LK were significantly associated with the outcome. The higher the initial L and lower the LK, the higher the risk of mortality in the hospital or within 6 months. Moreover, the higher the initial L and lower the 6 h LK, the longer was the LOS. A relation between the initial L/LK and the required therapy was found. The optimal cut-off for the 6-h LK is 38.1%. Patients with a 6 h LK >38.1% had a significantly higher chance of survival. Conclusions : A significant relationship between the L/6-h LK and the outcome and treatment was found. The optimal survival cut-off point of 6 h LK in our study was 38.1%.