TY - JOUR
TI - Adipose Tissue Lactate Clearance but Not Blood Lactate Clearance Is
Associated with Clinical Outcome in Sepsis or Septic Shock during the
Post-Resuscitation Period
AU - Ilias, Ioannis
AU - Apollonatou, Sofia
AU - Vassiliadi, Dimitra-Argyro and
AU - Nikitas, Nikitas
AU - Theodorakopoulou, Maria
AU - Diamantakis, Argyris
AU - and Kotanidou, Anastasia
AU - Dimopoulou, Ioanna
JO - Nature Metabolism
PY - 2018
VL - 8
TODO - 2
SP - null
PB - MDPI
SN - null
TODO - 10.3390/metabo8020028
TODO - microdialysis; intensive care unit; sepsis; lactate clearance; tissue
hypoxia; outcome
TODO - No study has directly measured tissue lactate clearance in patients with
sepsis during the post-resuscitation period. In this study we aimed to
assess in ICU patients with sepsis (n = 32) or septic shock (n =
79)-during the post-resuscitation phase-the relative kinetics of
blood/tissue lactate clearances and to examine whether these are
associated with outcome. We measured serially-over a 48-h period-blood
and adipose tissue interstitial fluid lactate levels (with
microdialysis) and we calculated lactate clearance. Statistics included
mixed model analysis, Friedman’s analysis of variance, Wilcoxon’s test,
Mann-Whitney’s test, receiver operating characteristics curves and
logistic regression. Forty patients died (28-day mortality rate = 28%).
Tissue lactate clearance was higher compared to blood lactate clearance
at 0-8, 0-12, 0-16, 0-20 and 0-24 h (all p < 0.05). Tissue lactate
clearance was higher in survivors compared to non-survivors at 0-12,
0-20 and 0-24 h (all p = 0.02). APACHE II along with tissue lactate
clearance <30% at 0-12, 0-20 and 0-24 h were independent outcome
predictors. We did not find blood lactate clearance to be related to
survival. Thus, in critically ill septic patients, elevated tissue (but
not blood) lactate clearance, was associated with a favorable clinical
outcome.
ER -