Adipose tissue lactate clearance but not blood lactate clearance is associated with clinical outcome in sepsis or septic shock during the post-resuscitation period

Ioannis Ilias*, Sofia Apollonatou, Dimitra Argyro Vassiliadi, Nikitas Nikitas, Maria Theodorakopoulou, Argyris Diamantakis, Anastasia Kotanidou, Ioanna Dimopoulou

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

Abstract

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.

Original languageEnglish
Article number28
JournalMetabolites
Volume8
Issue number2
DOIs
Publication statusPublished - Jun 2018
Externally publishedYes

ASJC Scopus subject areas

  • Endocrinology, Diabetes and Metabolism
  • Biochemistry
  • Molecular Biology

Keywords

  • Intensive care unit
  • Lactate clearance
  • Microdialysis
  • Outcome
  • Sepsis
  • Tissue hypoxia

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