- CPR/Resuscitation
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Utility of the early lactate area score as a prognostic marker for septic shock patients in the emergency department
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Gina Yu, Seung Joon Yoo, Sang-Hun Lee, June Sung Kim, Sungmin Jung, Youn-Jung Kim, Won Young Kim, Seung Mok Ryoo
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Acute Crit Care. 2019;34(2):126-132. Published online April 12, 2019
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DOI: https://doi.org/10.4266/acc.2018.00283
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Abstract
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- Background
The current Surviving Sepsis Campaign guidelines recommend the remeasurement of lactate levels if the initial lactate level is elevated; however, the prognostic value of lactate kinetics is limited and inconsistent. We attempted to determine the efficacy of the lactate area score (calculated from repeated lactate measurements during initial resuscitation) as a prognostic marker of septic shock in the emergency department (ED).
Methods We performed a retrospective study of adult patients with septic shock in the ED of a single tertiary medical center. Serial lactate levels were measured five times within 12 hours. We also compared the initial lactate level, maximum lactate level, and lactate area score. The lactate area score was defined as the sum of the area under the curve measured at 2, 4, 6, and 12 hours following the initial measurement.
Results A total of 362 patients were enrolled in this study, and the overall 28-day mortality was 31.8%. The lactate area score of serial lactate levels as well as the initial (median [interquartile range], 4.9 [3.4 to 10.5]; P=0.003) and maximum (7.3 [4.2 to 13.2]; P<0.001) lactate levels were significantly higher in the non-survivor group. However, in multivariate analysis, only the lactate area score (odds ratio, 1.013; 95% confidence interval, 1.007 to 1.019) was significantly associated with 28-day mortality.
Conclusions The early lactate area score may be a possible prognostic marker for predicting the 28-day mortality of adult septic shock patients. Further prospective interventional studies should be conducted to validate our results.
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Citations
Citations to this article as recorded by
- Electrochemical Detection of Biomarkers Via Affinity Binding with Functionalized Nanocomposite for Assessment of Tissue-Perfusion
Ariadna Schuck, Minhee Kang, Yong-Sang Kim Journal of Electrical Engineering & Technology.2024; 19(5): 3309. CrossRef - Role of lactate level in predicting admission need to intensive care unit and short term outcomes in patients with acute gastrointestinal bleeding
Hekmat Nashat Shawky, Hala Mostafa Kamel, Zain Elabdeen Ahmed Sayed, Hossam Mahmoud Abdelwahab The Egyptian Journal of Internal Medicine.2024;[Epub] CrossRef - Hierarchical Capability in Distinguishing Severities of Sepsis via Serum Lactate: A Network Meta-Analysis
Binlu Zhu, Ruixi Zhou, Jiangwei Qin, Yifei Li Biomedicines.2024; 12(2): 447. CrossRef - Mortality Prediction by Kinetic Parameters of Lactate and S-Adenosylhomocysteine in a Cohort of Critically Ill Patients
Jochen J. Schoettler, Kathrin Brohm, Sonani Mindt, Evelyn Jäger, Bianka Hahn, Tanja Fuderer, Holger A. Lindner, Verena Schneider-Lindner, Joerg Krebs, Michael Neumaier, Manfred Thiel, Franz-Simon Centner International Journal of Molecular Sciences.2024; 25(12): 6391. CrossRef - Serial evaluation of the serum lactate level with the SOFA score to predict mortality in patients with sepsis
Heemoon Park, Jinwoo Lee, Dong Kyu Oh, Mi Hyeon Park, Chae-Man Lim, Sang-Min Lee, Hong Yeul Lee Scientific Reports.2023;[Epub] CrossRef - Using time-course as an essential factor to accurately predict sepsis-associated mortality among patients with suspected sepsis
Shih-Chieh Yen, Chin-Chieh Wu, Yi-Ju Tseng, Chih-Huang Li, Kuan-Fu Chen Biomedical Journal.2023; : 100632. CrossRef - Association between normalized lactate load and in-hospital mortality in patients with acute myocardial infarction
Yue Wu, Nannan Huang, Tienan Sun, Biyang Zhang, Shiyu Zhang, Pengyu Zhang, Chunxia Zhang International Journal of Cardiology.2023; : 131658. CrossRef - Increased normalized lactate load is associated with higher mortality in both sepsis and non-sepsis patients: an analysis of the MIMIC-IV database
Han Chen, Shu-Rong Gong, Rong-Guo Yu BMC Anesthesiology.2022;[Epub] CrossRef - An integrated wearable microneedle array for the continuous monitoring of multiple biomarkers in interstitial fluid
Farshad Tehrani, Hazhir Teymourian, Brian Wuerstle, Jonathan Kavner, Ravi Patel, Allison Furmidge, Reza Aghavali, Hamed Hosseini-Toudeshki, Christopher Brown, Fangyu Zhang, Kuldeep Mahato, Zhengxing Li, Abbas Barfidokht, Lu Yin, Paul Warren, Nickey Huang, Nature Biomedical Engineering.2022; 6(11): 1214. CrossRef - Association between normalized lactate load and mortality in patients with septic shock: an analysis of the MIMIC-III database
Han Chen, Shu-Rong Gong, Rong-Guo Yu BMC Anesthesiology.2021;[Epub] CrossRef - Mortality prediction using a novel combination of biomarkers in the first day of sepsis in intensive care units
Junkun Liu, Chengwen Bai, Binbin Li, Aijun Shan, Fei Shi, Can Yao, Yu Zhang, Jin Wang, Weibu Chen, Manying Xie, Dehui Deng Scientific Reports.2021;[Epub] CrossRef - A Graphene-Based Enzymatic Biosensor Using a Common-Gate Field-Effect Transistor for L-Lactic Acid Detection in Blood Plasma Samples
Ariadna Schuck, Hyo Eun Kim, Júlia Konzen Moreira, Priscila Schmidt Lora, Yong-Sang Kim Sensors.2021; 21(5): 1852. CrossRef - Usefulness of presepsin in predicting the prognosis of patients with sepsis or septic shock: a retrospective cohort study
Jeong Suk Koh, Yoon Joo Kim, Da Hyun Kang, Jeong Eun Lee, Song-I Lee Yeungnam University Journal of Medicine.2021; 38(4): 318. CrossRef - Non-enzymatic lactic acid sensor based on AuPtNPs functionalized MoS2 nanosheet as electrode modified materials
Haolin Xiao, Liangli Cao, Huishan Qin, Shanshan Wei, Miao Gu, Feijun Zhao, Zhencheng Chen Journal of Electroanalytical Chemistry.2021; 903: 115806. CrossRef - Early lactate area scores and serial blood lactate levels as prognostic markers for patients with septic shock: a systematic review
Rozita Khodashahi, Soroush Sarjamee Infectious Diseases.2020; 52(7): 451. CrossRef - Recent lactate findings: is repeated serum lactate testing necessary in septic shock patients?
Moo Suk Park Acute and Critical Care.2019; 34(2): 155. CrossRef
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