ArticleAnnals of intensive care2021
Sympathetic stimulation increases serum lactate concentrations in patients admitted with sepsis: implications for resuscitation strategies.
Article in Annals of intensive care, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 11 papers.
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Who cites it
11 citing papers in PubMed, 16 citations in OpenAlex.
- Intraoperative lactate as an early risk marker in laparoscopic liver resection and its association with modifiable hemodynamic parameters: a retrospective cohort study.Journal of anesthesia · 2026Article
- Retrospective Cohort Analysis of TyG, TyG-SI, and TyG-Lac Indices as Predictors of 360-Day Mortality in Critically Ill Ischemic Stroke Patients.Journal of clinical medicine · 2026Article
- Beyond exercise and appetite: The expanding biology and therapeutic potential of N-lactoyl-phenylalanine.The Journal of pharmacology and experimental therapeutics · 2026Review
- Oral-Mucosal PCOResuscitation plus · 2024Article
- Relationship between lactate levels and 28-day mortality in pediatric sepsis: results from the pediatric intensive care database.BMC pediatrics · 2024Article
- Apelin-13 administration allows for norepinephrine sparing in a rat model of cecal ligation and puncture-induced septic shock.Intensive care medicine experimental · 2024Article
- The predictive value of serum lactate to forecast injury severity in trauma-patients increases taking age into account.European journal of trauma and emergency surgery : official publication of the European Trauma Society · 2024Article
- Comparison between traditional logistic regression and machine learning for predicting mortality in adult sepsis patients.Frontiers in medicine · 2024Article
- Association Between Lactate and 28-Day Mortality in Elderly Patients with Sepsis: Results from MIMIC-IV Database.Infectious diseases and therapy · 2023Article
- Elevated serum lactate levels and age are associated with an increased risk for severe injury in trauma team activation due to trauma mechanism.European journal of trauma and emergency surgery : official publication of the European Trauma Society · 2022Article
- Normal Saline Solution or Lactated Ringer's Solution to Enhance Lactate Clearance in Septic Patients After Initial Resuscitation in the ED: A Retrospective Cohort Trial.Open access emergency medicine : OAEM · 2021Article
Corrections and comments
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Authors and funding
7 authors at 2 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundDiametrically opposed positions exist regarding the deleterious effects of elevated lactate. There are data suggesting that it is a detrimental proxy for tissue hypoperfusion and anaerobic metabolism in sepsis and an alternative viewpoint is that some of the hyperlactatemia produced maybe adaptive. This study was conducted to explore the relationship between serum lactate levels, mean arterial blood pressure (MAP), and sympathetic stimulation in patients with sepsis.
methodsRetrospective analysis of prospectively collected clinical data from four community-based hospitals and one academic medical center. 8173 adults were included. Heart rate (HR) was used as a surrogate marker of sympathetic stimulation. HR, MAP, and lactate levels were measured upon presentation.
resultsMAP and HR interacted to affect lactate levels with the highest levels observed in patients with low MAP and high HR (3.6 mmol/L) and the lowest in patients with high MAP and low HR (2.2 mmol/L). The overall mortality rate was 12.4%. Each 10 beats/min increase in HR increased the odds of death 6.0% (95% CI 2.6% to 9.4%), each 1 mmol/L increase in lactate increased the odds of death 20.8% (95% CI 17.4% to 24.2%), whereas each 10 mmHg increase in MAP reduced the odds of death 12.3% (95% CI 9.2% to 15.4%). However, HR did not moderate or mediate the association between lactate and death.
conclusionsIn septic patients, lactate production was associated with increased sympathetic activity (HR ≥ 90) and hypotension (MAP < 65 mmHg) and was a significant predictor of mortality. Because HR, lactate, and MAP were associated with mortality, our data support the present strategy of using these measurements to gauge severity of illness upon presentation. Since HR did not moderate or mediate the association between lactate and death, criticisms alleging that lactate caused by sympathetic stimulation is adaptive (i.e., less harmful) do not appear substantiated.
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