Role of Arterial Serum Lactate as a Predictor of Undifferentiated Shock on Admission and its Outcome- A Cohort Study
Introduction: Patients with elevated serum lactate levels may be at risk for considerable morbidity and mortality and require a prompt, thoughtful and systematic approach for diagnosis and treatment. Aim: To find an association of on admission arterial serum lactate with outcome in Intensive Ca...
Guardado en:
| Autores principales: | , , , , |
|---|---|
| Formato: | article |
| Lenguaje: | EN |
| Publicado: |
JCDR Research and Publications Private Limited
2021
|
| Materias: | |
| Acceso en línea: | https://doaj.org/article/4791a64ab30c45fabb7911bccdb9f3cc |
| Etiquetas: |
Agregar Etiqueta
Sin Etiquetas, Sea el primero en etiquetar este registro!
|
| Sumario: | Introduction: Patients with elevated serum lactate levels may
be at risk for considerable morbidity and mortality and require a
prompt, thoughtful and systematic approach for diagnosis and
treatment.
Aim: To find an association of on admission arterial serum lactate
with outcome in Intensive Care Unit (ICU) patients.
Materials and Methods: This observational cohort study was
conducted on 168 patients at Poona Hospital and Research
Centre, Pune, India, between June 2018 to November 2019 after
obtaining Institutional Ethical Clearance. The patients included
were above 18 years of age who had Systolic Blood Pressure
(SBP) <90 mmHg, Heart Rate (HR) >100/min and Respiratory
Rate (RR) >20/min. The arterial serum lactate level were examined
on the day of admission, 12 hours and 24 hours. The need of
ionotropic support, duration of ICU stay and mortality in one
month was noted. The primary outcome measures were to study
the association of on admission arterial serum lactate level with
a duration of ICU stay and in-hospital mortality, whereas the
secondary outcome measure was to study the association of
on admission arterial serum lactate with the requirement of
ionotropic support. Analysis of data was done using Statistical
Package for Social Sciences for Windows, version 20.0.
Results: The incidence in-hospital mortality was 20 (22.7%)
out of 88 and 3 (3.8%) out of 80 in patients whose serum
lactate levels on admission were >36 mg/dL and ≤36 mg/dL,
respectively (p-value=0.002). The median duration of ICU stay
was six and three days in patients whose serum lactate levels
on admission were >36 mg/dL and ≤36 mg/dL, respectively
(p-value=0.001). A 87 (98.9%) patients whose serum lactate
levels >36 mg/dL on admission had the higher requirement of
inotropes as compared to 35 (50.7%) patients whose serum
lactate levels were ≤36 mg/dL. The percentage of patients
whose serum lactate level >36 mg/dL, had a significantly higher
Quick Sequential Organ Failure Assessment (qSOFA) scores
and higher Shock Index (SI). There was a statistically significant
positive correlation between serum lactate levels and qSOFA
score (r=0.555) and SI (r=0.559).
Conclusion: Initial serum lactate level was associated with
higher in-hospital mortality, the higher requirement of inotropic
support and longer duration of ICU stay. |
|---|