ArticleJournal of intensive care2016
Prognostic utility of plasma lactate measured between 24 and 48 h after initiation of early goal-directed therapy in the management of sepsis, severe sepsis, and septic shock.
Article in Journal of intensive care, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 15 papers, 1 of them a synthesis that pooled it.
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Who cites it
15 citing papers in PubMed, 1 synthesis or guideline pooled it, 41 citations in OpenAlex.
- The value of blood lactate kinetics in critically ill patients: a systematic review.Critical care (London, England) · 2016Pooled it
- Prognostic Value of 48-Hour Biomarker Reassessment Beyond Admission SOFA for 28-Day Mortality in Sepsis.Diagnostics (Basel, Switzerland) · 2026Article
- Time-related predictors for adverse events in polytrauma patients undergoing stand-alone definitive surgery.Journal of clinical orthopaedics and trauma · 2025Article
- Prognostic Significance of Lactate Clearance in Cardiogenic Pulmonary Edema in the Emergency Department.Medicina (Kaunas, Lithuania) · 2024Observational
- Lactate Profile Assessment-A Good Predictor of Prognosis in Patients with COVID-19 and Septic Shock Requiring Continuous Renal Therapy.Clinics and practice · 2024Article
- Article
- Can Lactate Clearance Predict Mortality in Critically Ill Children?Journal of pediatric intensive care · 2023Article
- Could lactate clearance be a marker of mortality in pediatric intensive care unit?Turkish journal of medical sciences · 2022Observational
- Admission Lactate Concentration, Base Excess, and Alactic Base Excess Predict the 28-Day Inward Mortality in Shock Patients.Journal of clinical medicine · 2022Article
- Assessment of Metabolic Dysfunction in Sepsis in a Retrospective Single-Centre Cohort.Critical care research and practice · 2021Article
- Lactate clearance prognosticates outcome in pediatric septic shock during first 24 h of intensive care unit admission.Journal of the Intensive Care Society · 2019Article
- Damage control orthopaedics: State of the art.World journal of orthopedics · 2019Article
- Letter to the Editor.Medical journal, Armed Forces India · 2017Article
- Early total care to early appropriate care - What every anesthesiologist must know!Journal of anaesthesiology, clinical pharmacologyReview
- Comparison of cardiac output, IVC diameters and lactate levels in prediction of mortality in patients in emergency department; An observational study.Pakistan journal of medical sciencesArticle
Corrections and comments
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Authors and funding
6 authors at 2 institutions in 1 country.
Funding
Abstract
backgroundBased on the proven efficacy of lactate in predicting mortality and morbidity in sepsis when measured early in the resuscitative protocol, our group hypothesized that this utility extends later in the course of care. This study sought to investigate the prognostic potential of plasma lactate clearance measured 24-48 h after the initiation of treatment for nonsurgical patients with sepsis, severe sepsis, and septic shock.
methodsPlasma lactate values, measured 24-48 h after the initiation of treatment, were collected in nonsurgical septic, severe septic, and septic shock patients. The primary outcome was 30-day mortality, while secondary outcomes included requirements for vasopressors and boluses of intravenous fluids. Analysis of these three outcomes was performed while controlling for clinical severity as measured by Sequential Organ Failure Assessment (SOFA), renal dysfunction, and hepatic dysfunction. Lactate clearance was defined as the percent change in plasma lactate levels measured after 24-48 h of treatment from the plasma lactate level at initial presentation.
resultsTwo hundred twenty-nine nonsurgical patients were divided into two groups, clearers (above median lactate clearance [31.6 %]) and nonclearers (below median lactate clearance [31.6 %]). The adjusted odds ratio of mortality in clearers compared to nonclearers was 0.39 (CI 0.20-0.76) (p = 0.006). For vasopressor requirement, the adjusted odds ratio was 0.41 (CI 0.21-0.79) in clearers compared to nonclearers (p = 0.008). For intravenous fluid bolus requirement, the adjusted odds ratio was 0.81 (CI 0.48-1.39) in clearers compared to nonclearers (p = 0.45).
conclusionsLower plasma lactate clearance 24-48 h after the initiation of treatment is associated with higher 30-day mortality and requirements for vasopressors in nonsurgical septic patients and may be a useful noninvasive measurement for guiding late-sepsis treatment. Further investigation looking at mechanisms and therapeutic targets to improve lactate clearance in late sepsis may improve patient mortality and outcomes.
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