Document Detail


Lactate concentrations in the rectal lumen in patients in early septic shock.
MedLine Citation:
PMID:  20560883     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Previously, we observed that rectal luminal lactate was higher in non-survivors compared with survivors of severe sepsis or septic shock persisting >24 h. The present study was initiated to further investigate this tentative association between rectal luminal lactate and mortality in a larger population of patients in early septic shock. METHODS: A prospective observational multicentre study of 130 patients with septic shock at six general ICU's of university hospitals. Six to 24 h after the onset of septic shock, the concentration of lactate in the rectal lumen was estimated by a 4-h equilibrium dialysis. Dialysate concentrations of lactate were determined using an auto-analyser. RESULTS: The overall 30-day mortality was 32%, with age and Simplified acute physiology scores II and sequential organ failure assessment scores being significantly higher in non-survivors. In contrast, there were no differences in concentrations of lactate in the rectal lumen [2.2 (1.4-4.1) and 2.8 (1.6-5.1) mmol/l (P=0.34)] (medians and 25th-75th percentiles) or arterial blood [2.1 (1.4-4.2) and 2.0 (1.3-3.2) mmol/l (P=0.15)] between non-survivors and survivors. The rectal-arterial difference of the lactate concentration was higher in survivors. There were no differences in blood pressure, noradrenaline dose or central venous oxygen saturation between the groups. CONCLUSION: In this prospective, observational study of unselected patients with early septic shock, there was no difference in the concentration of lactate in the rectal lumen between non-survivors and survivors. TRIAL REGISTRATION: Clinicaltrials.gov (no: NCT00197938).
Authors:
M Ibsen; J Tenhunen; J Wiis; T Waldau; A Ø Lauritsen; K Thornberg; H Joensen; A Perner
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Publication Detail:
Type:  Journal Article; Multicenter Study     Date:  2010-06-15
Journal Detail:
Title:  Acta anaesthesiologica Scandinavica     Volume:  54     ISSN:  1399-6576     ISO Abbreviation:  Acta Anaesthesiol Scand     Publication Date:  2010 Aug 
Date Detail:
Created Date:  2010-07-23     Completed Date:  2010-10-28     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0370270     Medline TA:  Acta Anaesthesiol Scand     Country:  England    
Other Details:
Languages:  eng     Pagination:  827-32     Citation Subset:  IM    
Affiliation:
Department of Intensive Care, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark. micibs@dadlnet.dk
Data Bank Information
Bank Name/Acc. No.:
ClinicalTrials.gov/NCT00197938
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MeSH Terms
Descriptor/Qualifier:
Aged
Biological Markers
Blood Pressure / physiology
Cohort Studies
Dialysis
Female
Humans
Lactic Acid / metabolism*
Male
Middle Aged
Norepinephrine / therapeutic use
Oxygen / blood
Predictive Value of Tests
Prospective Studies
Rectum / metabolism*
Shock, Septic / metabolism*,  mortality
Survival
Treatment Outcome
Vasoconstrictor Agents / therapeutic use
Chemical
Reg. No./Substance:
0/Biological Markers; 0/Vasoconstrictor Agents; 50-21-5/Lactic Acid; 51-41-2/Norepinephrine; 7782-44-7/Oxygen

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