Lactate kinetics in sepsis and septic shock: A review of the literature and rationale for further research

被引:67
作者
Chertoff J. [1 ]
Chisum M. [1 ]
Garcia B. [2 ]
Lascano J. [3 ]
机构
[1] University of Florida College of Medicine, Department of Medicine, 1600 SW Archer Road, Gainesville, 32608, FL
[2] University of Alabama-Birmingham, Division of Pulmonary, Allergy, and Critical Care, Birmingham, AL
[3] University of Florida, Division of Pulmonary Critical Care, Gainesville, FL
关键词
Early sepsis; Kinetics; Lactate; Late sepsis; Microvascular; Resuscitation; Sepsis; Shock;
D O I
10.1186/s40560-015-0105-4
中图分类号
学科分类号
摘要
Over the last two decades, there have been vast improvements in sepsis-related outcomes, largely resulting from the widespread adoption of aggressive fluid resuscitation and infection control. With increased understanding of the pathophysiology of sepsis, novel diagnostics and resuscitative interventions are being discovered. In recent years, few diagnostic tests like lactate have engendered more attention and research in the sepsis arena. Studies highlighting lactate's prognostic potential for mortality and other outcomes are ubiquitous and largely focus on the early stage of sepsis management, defined as the initial 6 h and widely referred to as the "golden hours." Additional investigations, although more representative of surgical and trauma patients, suggest that lactate measurements beyond 24 h from the initiation of resuscitation continue to have predictive and prognostic utility. This review summarizes the current research and evidence regarding lactate's utility as a prognosticator of clinical outcomes in both early and late sepsis management, defines the mechanism of lactate production and clearance, and identifies areas warranting further research. © 2015 Chertoff et al.
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