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  • Meeting abstract
  • Open Access

Serial lactate and prognosis in intensive care patients

  • 1 and
  • 1
Critical Care20015 (Suppl 3) :P89

https://doi.org/10.1186/cc1422

  • Published:

Keywords

  • Lactate
  • Intensive Care Unit
  • Temporal Variation
  • Care Patient
  • Emergency Medicine

Introduction

Despite the fact that serum lactate (Lact) is a byproduct of anaerobic metabolism [1], its utility as marker of prognosis for patients in the intensive care unit (ICU) is still controversial [2,3].

Objectives

(1) To verify if the two first dosages of Lact were different between survivors (S) and nonsurvivors (NS), and (2) to verify whether there is difference between S and NS at ICU in relation to the temporal variation of Lact levels in the first 24 h of ICU admission.

Method

This was a prospective study includinsg all patients admitted to the ICU during a 3-month period. Lact measurements were done (mmol/l) at ICU admission (LADM) and in the in the 3 following days (L1, L2, L3) according to the laboratory routine, making a total of until four measures per patient. The exclusion criteria were brain death at admission and patients who discharged or died before the L1 dosage. Demographic data were collected. Lact was compared between S and NS in four ways: LADM; L1; mean Lact; and variation between LADM and L1 in time by calculating the area under the curve. Data were analyzed using the package Statistica v5.0®. Means were compared using the nonpaired t-student test, and a P < 0.05 was considered statistically significant.

Results

A total of 90 patients were analyzed. Eleven (12%) were NS.

Conclusion

The dosages of Lact at admission, L1, mean Lact and permanence of high levels of Lact in the first hours in the ICU were different between S and NS, suggesting that serial dosages of Lact may be a useful prognostic marker in ICU patients.

Table

Data

Mean ± DP

P

LADM (mmol/l)

S = 2.44 ± 1.35

<0.00001

 

NS = 5.34 ± 3.86

 

L1 (mmol/l)

S = 2.17 ± 1.10

0.003

 

NS = 5.10 ± 5.30

 

Mean Lactate (mmol/l)

S=2.04 ± 0.70

<0.00001

 

NS = 4.79 ± 4.07

 

Mean hourly variation for

S = -0.03 ± 0.12

0.522

LADM and L1 (mmol/l)

NS = 0.02 ± 0.54

 

Area under the curve between

S = 33.89 ± 18.86

0.0001

LADM and L1 and time of the

NS = 67.70 ± 52.37

 

dosages

  

Time between the dosages

S = 14.81 ± 4.90

0.203

of LADM and L1

NS = 12.73 ± 6.02

 

Authors’ Affiliations

(1)
Hospital Governador Celso Ramos, Critical Care Unit, Florianópolis, Santa Catarina, Brazil

References

  1. Weil MH, Afifi AA: Experimental and clinical studies on lactate and pyruvate as indicators of severity of acute circulatory failure (shock). Circulation 1970, 41: 989-1001.View ArticlePubMedGoogle Scholar
  2. Vincent JL, Dufaye P, Berre J, et al.: Serial lactate determinations during circulatory shock. Crit Care Med 1983, 11: 449-451.View ArticlePubMedGoogle Scholar
  3. Bakker J, Gris P, Coffernils M, et al.: Serial blood lactate levels can predict the development of multiple organ failure following septic shock. Am J Surg 1996, 171: 221-226. 10.1016/S0002-9610(97)89552-9View ArticlePubMedGoogle Scholar

Copyright

© The Author(s) 2001

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