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Relationship between the sublingual microcirculation and lactate levels in patients with heart failure
Critical Care volume 12, Article number: P62 (2008)
Treatment of patients with severe heart failure aims at normalizing hemodynamic and metabolic parameters. We tested whether the sublingual functional capillary density (FCD), an indicator of tissue perfusion at the microvascular level, correlates with lactate levels in heart failure patients.
We investigated 12 heart failure patients, treated with inotropes, within 24 hours after hospital admission. Sidestream dark-field imaging was used to investigate the sublingual microcirculation. At least three video sequences of the microcirculation were recorded and analyzed. Microscan Analysis Software was used to measure the FCD, where the FCD was determined as the total length of perfused capillaries per field of view. Capillaries were defined as microvessels with a diameter <25 μm.
The mean arterial pressure was 75 (68–78) mmHg, lactate levels were 1.2 (1.0–1.7) mmol/l and SvO2 was 0.78 (0.65–0.84) mol/mol. The FCD was 11.7 (10.1–12.2) μm-1. The correlation between lactate and FCD is shown in Figure 1 (regression line: β1 = -0.88, P = 0.05).
In this study, FCD correlated with lactate levels. This finding is indicative for a relationship between global hemodynamics and the sublingual microcirculation in patients treated for heart failure. Based on the interim results, more patients will be included in this study for final analysis and conclusions.
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Den Uil, C., Lagrand, W., Klijn, E. et al. Relationship between the sublingual microcirculation and lactate levels in patients with heart failure. Crit Care 12, P62 (2008). https://doi.org/10.1186/cc6283
- Heart Failure
- Arterial Pressure
- Hospital Admission
- Video Sequence