Adipose Tissue Lactate Clearance but Not Blood Lactate Clearance Is Associated with Clinical Outcome in Sepsis or Septic Shock during the Post-Resuscitation Period
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/...
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2018-04-01
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author | Ioannis Ilias Sofia Apollonatou Dimitra-Argyro Vassiliadi Nikitas Nikitas Maria Theodorakopoulou Argyris Diamantakis Anastasia Kotanidou Ioanna Dimopoulou |
author_facet | Ioannis Ilias Sofia Apollonatou Dimitra-Argyro Vassiliadi Nikitas Nikitas Maria Theodorakopoulou Argyris Diamantakis Anastasia Kotanidou Ioanna Dimopoulou |
author_sort | Ioannis Ilias |
collection | DOAJ |
description | 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. |
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issn | 2218-1989 |
language | English |
last_indexed | 2024-04-12T18:25:40Z |
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spelling | doaj.art-bfc4942da18f457a8304870c50f8814a2022-12-22T03:21:14ZengMDPI AGMetabolites2218-19892018-04-01822810.3390/metabo8020028metabo8020028Adipose Tissue Lactate Clearance but Not Blood Lactate Clearance Is Associated with Clinical Outcome in Sepsis or Septic Shock during the Post-Resuscitation PeriodIoannis Ilias0Sofia Apollonatou1Dimitra-Argyro Vassiliadi2Nikitas Nikitas3Maria Theodorakopoulou4Argyris Diamantakis5Anastasia Kotanidou6Ioanna Dimopoulou7Endocrine Unit, Elena Venizelou Hospital, Athens 11521, GreeceSecond Department of Critical Care Medicine, Attikon University Hospital, National and Kapodistrian University of Athens, Medical School, Athens 10462, GreeceDepartment of Endocrinology, Evangelismos Hospital, Athens 10676, GreeceSecond Department of Critical Care Medicine, Attikon University Hospital, National and Kapodistrian University of Athens, Medical School, Athens 10462, GreeceSecond Department of Critical Care Medicine, Attikon University Hospital, National and Kapodistrian University of Athens, Medical School, Athens 10462, GreeceSecond Department of Critical Care Medicine, Attikon University Hospital, National and Kapodistrian University of Athens, Medical School, Athens 10462, GreeceFirst Department of Critical Care Medicine, Evangelismos Hospital, National and Kapodistrian University of Athens, Medical School, Athens 10676, GreeceFirst Department of Critical Care Medicine, Evangelismos Hospital, National and Kapodistrian University of Athens, Medical School, Athens 10676, GreeceNo 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.http://www.mdpi.com/2218-1989/8/2/28microdialysisintensive care unitsepsislactate clearancetissue hypoxiaoutcome |
spellingShingle | Ioannis Ilias Sofia Apollonatou Dimitra-Argyro Vassiliadi Nikitas Nikitas Maria Theodorakopoulou Argyris Diamantakis Anastasia Kotanidou Ioanna Dimopoulou Adipose Tissue Lactate Clearance but Not Blood Lactate Clearance Is Associated with Clinical Outcome in Sepsis or Septic Shock during the Post-Resuscitation Period Metabolites microdialysis intensive care unit sepsis lactate clearance tissue hypoxia outcome |
title | Adipose Tissue Lactate Clearance but Not Blood Lactate Clearance Is Associated with Clinical Outcome in Sepsis or Septic Shock during the Post-Resuscitation Period |
title_full | Adipose Tissue Lactate Clearance but Not Blood Lactate Clearance Is Associated with Clinical Outcome in Sepsis or Septic Shock during the Post-Resuscitation Period |
title_fullStr | Adipose Tissue Lactate Clearance but Not Blood Lactate Clearance Is Associated with Clinical Outcome in Sepsis or Septic Shock during the Post-Resuscitation Period |
title_full_unstemmed | Adipose Tissue Lactate Clearance but Not Blood Lactate Clearance Is Associated with Clinical Outcome in Sepsis or Septic Shock during the Post-Resuscitation Period |
title_short | Adipose Tissue Lactate Clearance but Not Blood Lactate Clearance Is Associated with Clinical Outcome in Sepsis or Septic Shock during the Post-Resuscitation Period |
title_sort | adipose tissue lactate clearance but not blood lactate clearance is associated with clinical outcome in sepsis or septic shock during the post resuscitation period |
topic | microdialysis intensive care unit sepsis lactate clearance tissue hypoxia outcome |
url | http://www.mdpi.com/2218-1989/8/2/28 |
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