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Hyperlactatemia

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https://www.readbyqxmd.com/read/28298660/hyperlactatemia-and-cardiac-surgery
#1
REVIEW
Jonathon Minton, David A Sidebotham
The normal blood lactate level is 0-2 mmol/L, and a value above 3-5 mmol/L is variably used to define hyperlactatemia. In cardiac surgical patients, hyperlactatemia can arise from both hypoxic and non-hypoxic mechanisms. The major non-hypoxic mechanism is likely stress-induced accelerated aerobic metabolism, in which elevated lactate results from a mass effect on the lactate/pyruvate equilibrium. The lactate/pyruvate ratio is normal (<20) in this circumstance. Hyperlactatemia can also result from impaired global or regional oxygen delivery, in which case the lactate/pyruvate ratio is typically elevated (>20)...
March 2017: Journal of Extra-corporeal Technology
https://www.readbyqxmd.com/read/28294557/double-blind-randomized-controlled-trial-of-the-routine-peri-operative-use-of-terlipressin-in-adult-living-donor-liver-transplantation
#2
Mettu Srinivas Reddy, Ilankumaran Kaliamoorthy, Akila Rajakumar, Selvakumar Malleeshwaran, Ellango Appuswamy, Sukanya Lakshmi, Joy Varghese, Mohamed Rela
BACKGROUND: Peri-operative terlipressin (Tp) during living donor liver transplantation (LDLT) has been shown to reduce intra-operative portal pressures and improve renal function. Its role and safety profile has never been evaluated in a double-blinded RCT. AIM: To evaluate the haemodynamic effects, clinical benefits and safety of peri-operative terlipressin infusion in adult LDLT. METHODS: This was a single centre double-blind RCT. Consenting adults with chronic liver disease and low risk of post-transplant renal dysfunction (PTRD) undergoing their first LDLT were randomized...
March 14, 2017: Liver Transplantation
https://www.readbyqxmd.com/read/28281216/a-hypoperfusion-context-may-aid-to-interpret-hyperlactatemia-in-sepsis-3-septic-shock-patients-a-proof-of-concept-study
#3
Leyla Alegría, Magdalena Vera, Jorge Dreyse, Ricardo Castro, David Carpio, Carolina Henriquez, Daniela Gajardo, Sebastian Bravo, Felipe Araneda, Eduardo Kattan, Pedro Torres, Gustavo Ospina-Tascón, Jean-Louis Teboul, Jan Bakker, Glenn Hernández
BACKGROUND: Persistent hyperlactatemia is particularly difficult to interpret in septic shock. Besides hypoperfusion, adrenergic-driven lactate production and impaired lactate clearance are important contributors. However, clinical recognition of different sources of hyperlactatemia is unfortunately not a common practice and patients are treated with the same strategy despite the risk of over-resuscitation in some. Indeed, pursuing additional resuscitation in non-hypoperfusion-related cases might lead to the toxicity of fluid overload and vasoactive drugs...
December 2017: Annals of Intensive Care
https://www.readbyqxmd.com/read/28255967/aerobic-and-anaerobic-swimming-force-evaluation-in-one-single-test-session-for-young-swimmers
#4
Filipe Antônio de Barros Sousa, Natalia Almeida Rodrigues, Leonardo Henrique Dalcheco Messias, Jair Borges Queiroz, Fulvia Barros Manchado-Gobatto, Claudio Alexandre Gobatto
This study aims to propose and validate the tethered swimming lactate minimum test (TSLacmin) estimating aerobic and anaerobic capacity in one single test session, using force as measurement parameter. 6 male and 6 female young swimmers (age=15.7±1.1 years; height=173.3±9.5 cm; weight=66.1±9.5 kg) performed 4 sessions comprising i) an all-out 30 s test and incremental test (TSLacmin); ii) 30 min of tethered swimming at constant intensity (2 sessions); iii) free-swimming time trials used to calculate critical velocity...
March 2, 2017: International Journal of Sports Medicine
https://www.readbyqxmd.com/read/28248722/mortality-is-greater-in-septic-patients-with-hyperlactatemia-than-with-refractory-hypotension
#5
Robert Gotmaker, Sandra L Peake, Andrew Forbes, Rinaldo Bellomo
BACKGROUND: In septic patients, it is uncertain whether isolated hyperlactatemia (lactate ≥ 4 mmol/L without refractory hypotension) can be used to diagnose septic shock and whether mortality rate differs from that of isolated refractory hypotension (refractory to 1000 ml or greater fluid bolus). AIMS: To compare baseline characteristics, treatments and outcomes of participants enrolled into the Australian Resuscitation in Sepsis Evaluation (ARISE) trial according to the presence of isolated hyperlactatemia or isolated refractory hypotension...
February 28, 2017: Shock
https://www.readbyqxmd.com/read/28237652/impact-of-epinephrine-contained-in-local-anesthetic-solution-on-serum-lactate-level-during-orthognathic-surgery
#6
Hidetaka Kuroda, Gaku Kawamura, Manabu Soya, Takayuki Kitamura, Tatsuya Ichinohe, Yoshitsugu Yamada
PURPOSE: There have been many discussions of a relation between endogenous and exogenous epinephrine and hyperlactatemia. This study aimed to identify the impact of epinephrine contained in a local anesthetic solution on serum lactate levels in patients who underwent orthognathic surgery. MATERIALS AND METHODS: This study was a retrospective record review of cases of maxillary and mandibular osteotomy at the Tokyo University Hospital (Tokyo, Japan) from January 2006 through December 2014...
February 3, 2017: Journal of Oral and Maxillofacial Surgery
https://www.readbyqxmd.com/read/28202033/use-of-stepwise-lactate-kinetics-oriented-hemodynamic-therapy-could-improve-the-clinical-outcomes-of-patients-with-sepsis-associated-hyperlactatemia
#7
Xiang Zhou, Dawei Liu, Longxiang Su, Bo Yao, Yun Long, Xiaoting Wang, Wenzhao Chai, Na Cui, Hao Wang, Xi Rui
BACKGROUND: Setting lactate kinetics at >30% might improve the clinical outcomes of patients with sepsis-associated hyperlactatemia. The aim of this study was to explore the outcome benefits of stepwise lactate kinetics vs central venous oxygen saturation (ScvO2)-oriented hemodynamic therapy at 6 h as the protocol goal during early resuscitation. METHODS: The relevant parameters and adverse events after different targets in 360 randomly assigned patients with sepsis-associated hyperlactatemia were recorded and compared...
February 16, 2017: Critical Care: the Official Journal of the Critical Care Forum
https://www.readbyqxmd.com/read/28196511/antiretroviral-therapy-related-adverse-effects-can-sub-saharan-africa-cope-with-the-new-test-and-treat-policy-of-the-world-health-organization
#8
Jobert Richie N Nansseu, Jean Joel R Bigna
BACKGROUND: Recent studies have shown that early antiretroviral therapy (ART) initiation results in significant HIV transmission reduction. This is the rationale behind the "test and treat" policy of the World Health Organization (WHO). Implementation of this policy will lead to an increased incidence of ART-related adverse effects, especially in sub-Saharan Africa (SSA). Is the region yet ready to cope with such a challenging issue? MAIN BODY: The introduction and widespread use of ART have drastically changed the natural history of HIV/AIDS, but exposure to ART leads to serious medication-related adverse effects mainly explained by mitochondrial toxicities, and the situation will get worse in the near future...
February 15, 2017: Infectious Diseases of Poverty
https://www.readbyqxmd.com/read/28186714/lactic-acidosis-with-chloramphenicol-treatment-in-a-child-with-cystic-fibrosis
#9
Isabelle Goyer, Massimiliano Iseppon, Céline Thibault, Rachid Abaji, Maja Krajinovic, Julie Autmizguine
Children with cystic fibrosis are commonly colonized with multi-resistant bacteria. In such patients, infectious exacerbation may require salvage therapy with uncommonly used antimicrobials, including chloramphenicol. Chloramphenicol is rarely used nowadays because of the associated severe adverse events. We describe the case of a 15-year-old female with terminal cystic fibrosis who required intravenous (IV) chloramphenicol treatment for a Burkholderia cepacia (B. cepacia) exacerbation. The child subsequently developed lactic acidosis and secondary respiratory compensation adding to her baseline respiratory distress...
January 30, 2017: Journal of Population Therapeutics and Clinical Pharmacology
https://www.readbyqxmd.com/read/28137926/prognostic-value-of-plasma-lactate-levels-in-a-retrospective-cohort-presenting-at-a-university-hospital-emergency-department
#10
Danith P A van den Nouland, Martijn C G J Brouwers, Patricia M Stassen
OBJECTIVES: The prognostic value of lactate in the setting of an emergency department (ED) has not been studied extensively. The goal of this study was to assess 28-day mortality in ED patients in whom lactate was elevated (≥4.0 mmol/L), <4.0 mmol/L or not determined and to study the impact of the underlying cause of hyperlactatemia, that is, type A (tissue hypoxia) or type B (non-hypoxia), on mortality. DESIGN: Retrospective study. SETTING: A secondary and tertiary referral centre in the Netherlands...
January 30, 2017: BMJ Open
https://www.readbyqxmd.com/read/28132131/evaluation-of-a-novel-5-group-classification-system-of-sepsis-by-vasopressor-use-and-initial-serum-lactate-in-the-emergency-department
#11
Kai E Swenson, James D Dziura, Ani Aydin, Jesse Reynolds, Charles R Wira
Prognostication in sepsis is limited by disease heterogeneity, and measures to risk-stratify patients in the proximal phases of care lack simplicity and accuracy. Hyperlactatemia and vasopressor dependence are easily identifiable risk factors for poor outcomes. This study compares incidence and hospital outcomes in sepsis based on initial serum lactate level and vasopressor use in the emergency department (ED). In a retrospective analysis of a prospectively identified dual-center ED registry, patients with sepsis were categorized by ED vasopressor use and initial serum lactate level...
January 28, 2017: Internal and Emergency Medicine
https://www.readbyqxmd.com/read/28120561/association-between-metformin-use-and-risk-of-lactic-acidosis-or-elevated-lactate-concentration-in-type-2-diabetes
#12
Eun Young Lee, Sena Hwang, Yong Ho Lee, Seo Hee Lee, Young Mi Lee, Hua Pyong Kang, Eugene Han, Woonhyoung Lee, Byung Wan Lee, Eun Seok Kang, Bong Soo Cha, Hyun Chul Lee
PURPOSE: Metformin can reduce diabetes-related complications and mortality. However, its use is limited because of potential lactic acidosis-associated adverse effects, particularly in renal impairment patients. We aimed to investigate the association of metformin use with lactic acidosis and hyperlactatemia in patients with type 2 diabetes. MATERIALS AND METHODS: This was a cross-sectional study from a tertiary university-affiliated medical center. A total of 1954 type 2 diabetes patients were recruited in 2007-2011, and stratified according to the estimated glomerular filtration rate of 60 mL/min/1...
March 2017: Yonsei Medical Journal
https://www.readbyqxmd.com/read/28114187/nevirapine-pharmacokinetics-and-safety-in-neonates-receiving-combination-antiretroviral-therapy-for-prevention-of-vertical-hiv-transmission
#13
Elaine Lau, Jason Brophy, Lindy Samson, Fatima Kakkar, Douglas Campbell, Mark H Yudin, Kellie Murphy, Winnie Seto, David Colantonio, Stanley E Read, Ari Bitnun
BACKGROUND: Nevirapine (NVP)-based combination antiretroviral therapy (cART) is routinely prescribed to infants deemed at high risk of vertical HIV infection in our centers. We evaluated NVP pharmacokinetics and safety of this regimen. METHODS: Neonates were recruited prospectively between September 2012 and April 2015 or enrolled retrospectively if treated similarly prior to prospective study initiation. NVP was dosed at 150 mg/m daily for 14 days, then twice daily for 14 days...
January 20, 2017: Journal of Acquired Immune Deficiency Syndromes: JAIDS
https://www.readbyqxmd.com/read/28099638/risk-factors-for-agitation-in-critically-ill-patients
#14
Thiago Miranda Lopes de Almeida, Luciano Cesar Pontes de Azevedo, Paulo Maurício Garcia Nosé, Flavio Geraldo Resende de Freitas, Flávia Ribeiro Machado
Objective: To evaluate the incidence of agitation in the first 7 days after intensive care unit admission, its risk factors and its associations with clinical outcomes. Methods: This single-center prospective cohort study included all patients older than 18 years with a predicted stay > 48 hours within the first 24 hours of intensive care unit admission. Agitation was defined as a Richmond Agitation Sedation Scale score ≥ +2, an episode of agitation or the use of a specific medication recorded in patient charts...
October 2016: Revista Brasileira de Terapia Intensiva
https://www.readbyqxmd.com/read/28060152/an-elevated-low-cardiac-output-syndrome-score-is-associated-with-morbidity-in-infants-after-congenital-heart-surgery
#15
Kalia P Ulate, Ofer Yanay, Howard Jeffries, Harris Baden, Jane L Di Gennaro, Jerry Zimmerman
OBJECTIVES: To evaluate an empirically derived Low Cardiac Output Syndrome Score as a clinical assessment tool for the presence and severity of Low Cardiac Output Syndrome and to examine its association with clinical outcomes in infants who underwent surgical repair or palliation of congenital heart defects. DESIGN: Prospective observational cohort study. SETTING: Cardiac ICU at Seattle Children's Hospital. PATIENTS: Infants undergoing surgical repair or palliation of congenital heart defects...
January 2017: Pediatric Critical Care Medicine
https://www.readbyqxmd.com/read/28019037/effect-of-dexamethasone-on-resting-blood-lactate-concentrations-in-horses
#16
K Mizen, J Woodman, S R Boysen, C Wagg, P Greco-Otto, R Léguillette, M-F Roy
BACKGROUND: Blood lactate concentration is a marker of tissue perfusion and helps guide therapeutic interventions in critically ill horses. In both humans and dogs, administration of corticosteroids can increase blood lactate concentration, leading to type B hyperlactatemia. This effect could be a consequence of the impact of corticosteroids on glucose metabolism. OBJECTIVES: To investigate the effects of daily IM dexamethasone administration on blood lactate and glucose concentrations in horses...
January 2017: Journal of Veterinary Internal Medicine
https://www.readbyqxmd.com/read/28008731/mitochondrial-respiratory-chain-complex-i-deficiency-causes-intractable-gastrointestinal-symptoms
#17
Hiroki Kuranobu, Jun Murakami, Naomi Kuranobu, Ken Okamoto, Kei Murayama, Susumu Kanzaki
We report the case of a 13-month-old girl with frequent vomiting, intractable diarrhea, hyperlactatemia, and liver dysfunction. Although the symptoms were treatment resistant, enteral nutrition formula containing medium-chain triglycerides reduced the weight loss, vomiting, and diarrhea. Immunostaining of mitochondrial respiratory chain (MRC) complexes of the colonic mucosa confirmed the diagnosis of MRC complex I deficiency. This case shows that this disease should be included in the differential diagnosis of hyperlactatemia and intractable, cryptogenic gastrointestinal symptoms...
December 2016: Pediatrics International: Official Journal of the Japan Pediatric Society
https://www.readbyqxmd.com/read/28006434/lactate-minimum-underestimates-the-maximal-lactate-steady-state-in-swimming-mice
#18
COMPARATIVE STUDY
Natalia Almeida Rodrigues, Adriana Souza Torsoni, Thais Fante, Ivan Gustavo Masselli Dos Reis, Claudio Alexandre Gobatto, Fúlvia Barros Manchado-Gobatto
The intensity of lactate minimum (LM) has presented a good estimate of the intensity of maximal lactate steady-state (MLSS); however, this relationship has not yet been verified in the mouse model. We proposed validating the LM protocol for swimming mice by investigating the relationship among intensities of LM and MLSS as well as differences between sexes, in terms of aerobic capacity. Nineteen mice (male: 10, female: 9) were submitted to the evaluation protocols for LM and MLSS. The LM protocol consisted of hyperlactatemia induction (30 s exercise (13% body mass (bm)), 30 s resting pause and exhaustive exercise (13% bm), 9 min resting pause and incremental test)...
January 2017: Applied Physiology, Nutrition, and Metabolism, Physiologie Appliquée, Nutrition et Métabolisme
https://www.readbyqxmd.com/read/27998289/effects-of-low-doses-of-esmolol-on-cardiac-and-vascular-function-in-experimental-septic-shock
#19
Chaojie Wei, Huguette Louis, Margaux Schmitt, Eliane Albuisson, Sophie Orlowski, Bruno Levy, Antoine Kimmoun
BACKGROUND: Administration of a selective β1-blocker, such as esmolol, in human septic shock has demonstrated cardiovascular protective effects related to heart rate reduction. Certain experimental data also indicate that esmolol exerts systemic anti-inflammatory and beneficial effects on vascular tone. Thus, the present study aimed to determine whether a non-chronotropic dose of esmolol maintains its protective cardiovascular and anti-inflammatory effects in experimental septic shock...
December 21, 2016: Critical Care: the Official Journal of the Critical Care Forum
https://www.readbyqxmd.com/read/27986334/septic-shock-without-hyperlactatemia-a-case-report
#20
Johnathan Lebaron, Robert J Leonard
No abstract text is available yet for this article.
December 12, 2016: American Journal of Emergency Medicine
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