Περίληψη:
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.
Συγγραφείς:
Ilias, Ioannis
Apollonatou, Sofia
Vassiliadi, Dimitra-Argyro and
Nikitas, Nikitas
Theodorakopoulou, Maria
Diamantakis, Argyris
and Kotanidou, Anastasia
Dimopoulou, Ioanna
