ArticleScientific reports2021
Understanding critically ill sepsis patients with normal serum lactate levels: results from U.S. and European ICU cohorts.
Article in Scientific reports, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 23 papers.
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Who cites it
23 citing papers in PubMed, 40 citations in OpenAlex.
- Dissipation of the mitochondrial proton motive force drives sepsis pathogenesis and explains hyperlactatemia's predictive value in sepsis mortality.World journal of critical care medicine · 2026Review
- Early Physiological Changes Before Rapid Response Team Activation Differentiate Patients Requiring ICU Transfer: A Retrospective Cohort Study.Journal of clinical medicine · 2026Article
- Lactate: elucidating its indispensable role in human health.Molecular cancer · 2026Review
- Normal initial lactate level in sepsis patients: is lactate still useful for prognosis prediction?World journal of emergency medicine · 2026Article
- Combined lactate, base excess, and MEWS score as predictors of ICU transfer from the emergency department: a retrospective cohort study.Frontiers in medicine · 2026Article
- Peak Lactate Within 24 h and Mortality in Septic Shock Patients Receiving Continuous Renal Replacement Therapy: A Real-World Cohort from an Asian ICU (2018-2020).Life (Basel, Switzerland) · 2025Article
- Admission lactate and short-term mortality in the geriatric ICU: comparison with established severity scores.Aging clinical and experimental research · 2025Article
- Recommendations for the use of biomarkers for the management of adults with sepsis: a scoping review and critical appraisal.BMJ open · 2025Article
- Early initiated noradrenaline versus fluid therapy for hypotension and shock in the emergency department (VASOSHOCK): a protocol for a pragmatic, multi-center, superiority, randomized controlled trial.Scandinavian journal of trauma, resuscitation and emergency medicine · 2025Article
- Relationship between lactate levels and 28-day mortality in pediatric sepsis: results from the pediatric intensive care database.BMC pediatrics · 2024Article
- Review
- Lactate: The Fallacy of Oversimplification.Biomedicines · 2023Review
- Nicotinamide Antagonizes Lipopolysaccharide-Induced Hypoxic Cell Signals in Human Macrophages.Journal of immunology (Baltimore, Md. : 1950) · 2023Article
- Emerging concepts in the care of patients with cirrhosis and septic shock.World journal of hepatology · 2023Review
- Association between the timing of ICU admission and mortality in patients with hospital-onset sepsis: a nationwide prospective cohort study.Journal of intensive care · 2023Article
- Prognostic factors for patients with hematologic malignancies admitted to the intensive care unit: is allogeneic transplantation still a risk factor?Annals of hematology · 2023Article
- Distinct subsets of neutrophils crosstalk with cytokines and metabolites in patients with sepsis.iScience · 2023Article
- Association Between Lactate and 28-Day Mortality in Elderly Patients with Sepsis: Results from MIMIC-IV Database.Infectious diseases and therapy · 2023Article
- 28-day sepsis mortality prediction model from combined serial interleukin-6, lactate, and procalcitonin measurements: a retrospective cohort study.European journal of clinical microbiology & infectious diseases : official publication of the European Society of Clinical Microbiology · 2023Article
- What Is Left for Real-Life Lactate Monitoring? Current Advances in Electrochemical Lactate (Bio)Sensors for Agrifood and Biomedical Applications.Biosensors · 2022Review
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Authors and funding
11 authors at 5 institutions in 3 countries.
Funding
Abstract
While serum lactate level is a predictor of poor clinical outcomes among critically ill patients with sepsis, many have normal serum lactate. A better understanding of this discordance may help differentiate sepsis phenotypes and offer clues to sepsis pathophysiology. Three intensive care unit datasets were utilized. Adult sepsis patients in the highest quartile of illness severity scores were identified. Logistic regression, random forests, and partial least square models were built for each data set. Features differentiating patients with normal/high serum lactate on day 1 were reported. To exclude that differences between the groups were due to potential confounding by pre-resuscitation hyperlactatemia, the analyses were repeated for day 2. Of 4861 patients included, 47% had normal lactate levels. Patients with normal serum lactate levels had lower 28-day mortality rates than those with high lactate levels (17% versus 40%) despite comparable physiologic phenotypes. While performance varied between datasets, logistic regression consistently performed best (area under the receiver operator curve 87-99%). The variables most strongly associated with normal serum lactate were serum bicarbonate, chloride, and pulmonary disease, while serum sodium, AST and liver disease were associated with high serum lactate. Future studies should confirm these findings and establish the underlying pathophysiological mechanisms, thus disentangling association and causation.
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