TY - JOUR
T1 - 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
AU - Nikitas, Nikitas
AU - Theodorakopoulou, Maria
AU - Diamantakis, Argyris
AU - Kotanidou, Anastasia
AU - Dimopoulou, Ioanna
N1 - Publisher Copyright:
© 2018 by the authors. Licensee MDPI, Basel, Switzerland.
PY - 2018/6
Y1 - 2018/6
N2 - 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.
AB - 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.
KW - Intensive care unit
KW - Lactate clearance
KW - Microdialysis
KW - Outcome
KW - Sepsis
KW - Tissue hypoxia
UR - http://www.scopus.com/inward/record.url?scp=85046482136&partnerID=8YFLogxK
U2 - 10.3390/metabo8020028
DO - 10.3390/metabo8020028
M3 - Article
AN - SCOPUS:85046482136
SN - 2218-1989
VL - 8
JO - Metabolites
JF - Metabolites
IS - 2
M1 - 28
ER -