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  • Open Access

Lactate index and survival in hospital-acquired septic shock

  • 1,
  • 1,
  • 2 and
  • 1
Critical Care201115 (Suppl 1) :P43

  • Published:


  • Lactate
  • Adrenaline
  • Septic Shock
  • Severe Sepsis
  • Blood Lactate


Severe sepsis is characterised by profound metabolic and inflammatory derangement, which can lead to multiorgan failure and death. During septic shock, oxygen delivery may fail to meet tissue demand resulting in increased oxygen extraction. Once tissue needs are no longer met, an oxygen debt with global tissue hypoxia and associated hyperlactataemia ensues. Several studies have shown that blood lactate may be used as a marker of global tissue hypoxia and prognosis in shock states.


Forty patients requiring adrenaline therapy for a first episode of septic shock acquired >24 hours after admission to the ICU had blood lactate levels measured 2-hourly over a 24-hour period. Adrenaline therapy was escalated until the target mean arterial pressure was reached. The lactate index was calculated as the ratio of maximum lactate increase to the adrenaline increase.


Lactate increased from 2.3 to 2.9 mmol/l (P = 0.024) and the mean adrenaline increase was 0.14 μg/kg/minute. Peak lactate correlated with peak adrenaline (rho = 0.34, P = 0.032). Lactate index was the only independent predictor of survival after controlling for age and APACHE II score (OR = 1.14, 95% CI = 1.03 to 1.26, P = 0.009).


A high lactate following adrenaline administration may be a beneficial and appropriate response.

Authors’ Affiliations

University of Witwatersrand, Johannesburg, South Africa
University of Queensland, Brisbane, Australia


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© Omar et al. 2011

This article is published under license to BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.