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VOLUME 26 , ISSUE 5 ( May, 2022 ) > List of Articles

Original Article

Study of Significance of Serum Lactate Kinetics in Sepsis as Mortality Predictor

Mit Chaudhari, Nagina Agarwal

Keywords : Lactate kinetics, Lactate clearance, Mortality prediction, Sepsis, Serum lactate

Citation Information : Chaudhari M, Agarwal N. Study of Significance of Serum Lactate Kinetics in Sepsis as Mortality Predictor. Indian J Crit Care Med 2022; 26 (5):591-595.

DOI: 10.5005/jp-journals-10071-23935

License: CC BY-NC 4.0

Published Online: 20-05-2022

Copyright Statement:  Copyright © 2022; The Author(s).


Abstract

Introduction: Sepsis is one of the leading causes of death worldwide. Serum lactate is being used in sepsis for diagnostic and prognostic purposes for years now. In this study, we shed light over a novel use of lactate in form of various clearance parameters to determine mortality in septic patients at the 28th day. Materials and methods: In our study, 200 patients with sepsis were included using quick sequential organ failure assessment (qSOFA) score and their lactate levels were measured at the time of admission (0 hour) and 24 hours after admission. Lactate clearance parameters (absolute and relative lactate clearance, lactate clearance rate) were calculated. All patients were followed up for a period of 28 days to determine the outcome, and data analysis was done accordingly. Results and conclusion: Our study showed that higher SOFA score, qSOFA score, and serum lactate levels were associated with increased 28th-day mortality. Low absolute, relative lactate clearance and lactate clearance rate were also associated with poor outcomes. The best cutoffs to predict poor outcomes were serum lactate level at 24 hours ≥4 mmol/L and relative lactate clearance ≤40.3% with good sensitivity and specificity.


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  1. Linde-Zwirble WT, Angus DC. Severe sepsis epidemiology: sampling, selection, and society. Crit Care 2004;8(4):222–226. DOI: 10.1186/cc2917.
  2. Filho RR, Rocha LL, Corrêa TD, Souza Pessoa CM, Colombo G, Cesar Assuncao MS. Blood lactate levels cutoff and mortality prediction in sepsis – Time for a reappraisal? A retrospective cohort study. Shock 2016;46:480–485. DOI: 10.1097/SHK.0000000000000667.
  3. Singer M, Deutschman CS, Seymour CW, Shankar-Hari M, Annane D, Bauer M, et al. The third international consensus definitions for sepsis and septic shock (sepsis-3). JAMA 2016;315:801–810. DOI: 10.1001/jama.2016.0287.
  4. Dellinger RP, Levy M, Rhodes A, Annane D, Gerlach H, Opal SM, et al. Surviving sepsis campaign: international guidelines for management of severe sepsis and septic shock: 2012. Crit Care Med 2013;41:580–637. DOI: 10.1097/CCM.0b013e31827e83af.
  5. Surana N, Kasper D. Approach to the patient with infectious disease. In: Kasper DL, Fauci AS, Hauser SL, Longo DL, Jameson JL, Loscalzo J, editors. Harrison's Principles of Internal Medicine. 20th ed. 2020. p. 859–866.
  6. Howell MD, Davis AM. Management of sepsis and septic shock. JAMA – J Am Med Assoc 2017;317:847–848. DOI: 10.1001/jama.2017.0131.
  7. Nguyen HB, Rivers EP, Knoblich BP, Jacobsen G, Muzzin A, Ressler JA, et al. Early lactate clearance is associated with improved outcome in severe sepsis and septic shock. Crit Care Med 2004;32:1637–1642. DOI: 10.1097/01.CCM.0000132904.35713.A7.
  8. Ryoo SM, Lee JB, Lee YS, Lee JH, Lim KS, Huh JW, et al. Lactate level versus lactate clearance for predicting mortality in patients with septic shock defined by Sepsis-3. Crit Care Med 2018;46:e489–e495. DOI: 10.1097/CCM.0000000000003030.
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