OBJECTIVES To determine whether lactate levels and base deficits in critically ill surgical intensive care unit (SICU) patients correlate and whether either measure is a significant indicator of mortality and morbidity. METHODS A review was made of 137 SICU patients who had serial lactate and blood gas measurements. Patients were stratified by absolute lactate and base deficit values as well ...

INTRODUCTION Initial lactate level, lactate clearance, C-reactive protein, and procalcitonin in critically ill patients with sepsis are associated with hospital mortality. However, no study has yet discovered which factor is most important for mortality in severe sepsis patients with lactic acidosis. We sought to clarify this issue in patients with lactic acidosis who were supplementing with so...

Lactic acidosis is common in critical care; by contrast, a subtype called alcohol-associated lactic acidosis (AALA) is rarely encountered. The primary purpose of this study was to determine the prognosis of AALA in critically ill patients and the second aim was to determine whether the survival was associated to the peak blood lactate concentration. An 8-year retrospective analysis of adult pat...

Gastric dilatation-volvulus is an acute life-threatening condition that primarily affects large-breed dogs. By definition, the initiating event of the syndrome involves an abnormal entrapment and accumulation of fluid and air within the gastric lumen that results in extreme, traumatic distention of the stomach (dilatation) and variable rotation of the stomach on its long axis (volvulus). Early ...

BACKGROUND Recent clinical studies have confirmed the strong prognostic value of persistent hyperlactatemia and delayed lactate clearance in septic shock. Several potential hypoxic and nonhypoxic mechanisms have been associated with persistent hyperlactatemia, but the relative contribution of these factors has not been specifically addressed in comprehensive clinical physiological studies. Our ...

In a recent article in Critical Care, Tapia and colleagues evaluated the relationship between exogenous lactate clearance and liver perfusion in a short-term model of endotoxemic shock [1]. The authors concluded that the very low portal-hepatic vein lactate gradient was indicative of the inability of the liver to metabolize the increased lactate load. Although we believe that the authors addres...

INTRODUCTION Implementation of the Surviving Sepsis Campaign (SSC) guidelines has been associated with improved outcome in patients with severe sepsis. Resolution of lactate elevations or lactate clearance has also been shown to be associated with outcome. The purpose of the present study was to examine the compliance and effectiveness of the SSC resuscitation bundle with the addition of lactat...

OBJECTIVE To describe the effect of liver disease (LD) on lactate clearance during early sepsis resuscitation. METHODS This is a multicenter randomized clinical trial. An initial lactate >2 mmol/L and subsequent serum lactate measurement within 6 hours were required for inclusion. LD was categorized by two methods: 1) past medical history (PMH) categorized as no LD, mild LD (no Child's score ...

UNLABELLED Lactate is a key myocardial energy source. Lactate metabolism is altered in a variety of conditions, such as exercise and diabetes mellitus. However, to our knowledge, noninvasive quantitative measurements of myocardial lactate metabolism have never been performed because of the lack of an adequate radiotracer. In this study we tested L-3-(11)C-lactate ((11)C-lactate) as such a trace...