Document Detail


Prevalence and characteristics of nonlactate and lactate expressors in septic shock.
MedLine Citation:
PMID:  22440322     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
PURPOSE: The study's objective was to determine the proportion and patient characteristics of patients in vasopressor-dependent septic shock who presented without lactatemia.
METHODS: A retrospective review of patients presenting to an urban tertiary-care emergency department between December 2007 and September 2008 was conducted. Patients with a final diagnosis of septic shock requiring vasopressors were divided, based on initial lactate, to nonlactate expressors (0-2.4 mmol/L), intermediate (2.5-3.9 mmol/L), and high (>4.0 mmol/L) lactate groups.
RESULTS: Among 123 patients with vasopressor-dependent septic shock, 55 (45%) were nonlactate expressors (lactate ≤ 2.4 mmol/L). Acute liver injury, history of liver disease, and presence of bacteremia were associated with elevated lactate.
CONCLUSION: Almost one-half of patients with vasopressor-dependent septic shock did not express lactate on presentation, although a high mortality rate remains in this population. We found a significant association between lactate expressors and liver disease and between lactate expressors and positive blood cultures. The use of lactatemia as the sole indicator of need for additional intravenous fluid or an end point of resuscitation in septic shock may be inadequate.
Authors:
Andrea Freyer Dugas; Julie Mackenhauer; Justin D Salciccioli; Michael N Cocchi; Shiva Gautam; Michael W Donnino
Publication Detail:
Type:  Journal Article; Research Support, N.I.H., Extramural     Date:  2012-03-21
Journal Detail:
Title:  Journal of critical care     Volume:  27     ISSN:  1557-8615     ISO Abbreviation:  J Crit Care     Publication Date:  2012 Aug 
Date Detail:
Created Date:  2012-07-24     Completed Date:  2012-12-18     Revised Date:  2013-08-14    
Medline Journal Info:
Nlm Unique ID:  8610642     Medline TA:  J Crit Care     Country:  United States    
Other Details:
Languages:  eng     Pagination:  344-50     Citation Subset:  IM    
Copyright Information:
Copyright © 2012 Elsevier Inc. All rights reserved.
Affiliation:
Department of Emergency Medicine, Beth Israel Deaconess Medical Center, Boston, MA 02215, USA.
Export Citation:
APA/MLA Format     Download EndNote     Download BibTex
MeSH Terms
Descriptor/Qualifier:
Aged
Aged, 80 and over
Bacteremia / epidemiology
Comorbidity
Emergency Service, Hospital / statistics & numerical data
Female
Hospitals, University / statistics & numerical data
Hospitals, Urban / statistics & numerical data
Humans
Lactic Acid / biosynthesis*
Liver Diseases / epidemiology
Male
Middle Aged
Prevalence
Prognosis
Retrospective Studies
Shock, Septic / blood*,  drug therapy*,  epidemiology,  microbiology
Vasoconstrictor Agents / administration & dosage*,  therapeutic use
Grant Support
ID/Acronym/Agency:
R21AT005119/AT/NCCAM NIH HHS; UL1 RR025758/RR/NCRR NIH HHS; UL1 RR025758/RR/NCRR NIH HHS
Chemical
Reg. No./Substance:
0/Vasoconstrictor Agents; 50-21-5/Lactic Acid
Comments/Corrections

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


Previous Document:  The aging musculoskeletal system and obesity-related considerations with exercise.
Next Document:  Prediction of extubation failure in medical intensive care unit patients.