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Hyperlactatemia

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https://www.readbyqxmd.com/read/28417525/metformin-associated-lactic-acidosis-mala-moving-towards-a-new-paradigm
#1
REVIEW
Jean-Daniel Lalau, Farshad Kajbaf, Alessandro Protti, Mette Marie Christensen, Marc-Etienne De Broe, Nicolas Wiernsperger
Although metformin has been used for over 60 years, the balance between the drug's beneficial and adverse effects is still subject to debate. Following an analysis of how cases of so-called "metformin-associated lactic acidosis" (MALA) are reported in the literature, the present article reviews the pitfalls to be avoided when assessing the purported association between metformin and lactic acidosis. By starting from pathophysiological considerations, we propose a new paradigm for lactic acidosis in metformin-treated patients...
April 17, 2017: Diabetes, Obesity & Metabolism
https://www.readbyqxmd.com/read/28407851/time-dependent-changes-and-prognostic-value-of-lactatemia-during-the-first-24%C3%A2-h-of-life-in-brachycephalic-newborn-dogs
#2
C Castagnetti, M Cunto, C Bini, J Mariella, S Capolongo, D Zambelli
Blood lactate concentration is known to be a good prognostic indicator associated with the severity of illness and the patient's outcome both in human and veterinary medicine. It also plays a significant role in the assessment of the newborn, being a good indicator of fetal hypoxia and the ideal predictor of morbidity at term in babies. In veterinary neonatal medicine, hyperlactatemia is considered a valid prognostic marker in critically ill foals; moreover, blood lactate measurement has been proposed for the evaluation of newborn viability and the assessment of fetal distress during delivery in dogs...
May 2017: Theriogenology
https://www.readbyqxmd.com/read/28403066/non-hemodynamic-effects-of-catecholamines
#3
Clair Hartmann, Peter Radermacher, Martin Wepler, Benedikt Nubaum
Circulatory shock is defined as an imbalance between tissue oxygen supply and demand, and mostly results from a loss of blood volume, cardiac pump failure and/or reduction of vasomotor tone. The clinical hallmarks of circulatory shock are arterial hypotension and lactate acidosis. Since the degree and duration of hypotension are major determinants of outcome, vasopressor administration represents a cornerstone therapy to treat these patients. Current guidelines recommend the use of catecholamines as the drug of first choice...
April 11, 2017: Shock
https://www.readbyqxmd.com/read/28390870/insulin-not-glutamine-dipeptide-reduces-lipases-expression-and-prevents-fat-wasting-and-weight-loss-in-walker-256-tumor-bearing-rats
#4
Hely de Morais, Flaviane de Fatima Silva, Francemilson Goulart da Silva, Milene Ortiz Silva, Maria Fernanda Rodrigues Graciano, Maria Isabel Lovo Martins, Ângelo Rafael Carpinelli, Tânia Longo Mazucco, Roberto Barbosa Bazotte, Helenir Medri de Souza
Cachexia is the main cause of mortality in advanced cancer patients. We investigated the effects of insulin (INS) and glutamine dipeptide (GDP), isolated or associated, on cachexia and metabolic changes induced by Walker 256 tumor in rats. INS (NPH, 40 UI/kg, sc) or GDP (1.5g/kg, oral gavage) was once-daily administered during 11 days after tumor cell inoculation. GDP, INS or INS+GDP treatments did not influence the tumor growth. However, INS and INS+GDP prevented retroperitoneal fat wasting and body weight loss of tumor-bearing rats...
April 6, 2017: European Journal of Pharmacology
https://www.readbyqxmd.com/read/28383617/plasma-amino-acids-of-the-transsulfuration-pathway-and-plasma-lactate-in-septic-patients
#5
C Chiarla, I Giovannini, G Miggiano
OBJECTIVES: In sepsis increasing plasma lactate, even if unrelated to hypoperfusion and hypoxia, is a cause of concern. Among the patterns associated with increasing lactate, several plasma amino acid (AA) abnormalities, more in particular those of sulfur AAs, have remained unexplored, and their assessment has been the purpose of our study. MATERIALS AND METHODS: A systematic and detailed analysis of 183 simultaneous determinations of plasma AA-grams and lactate, from 12 trauma surgery patients who had developed sepsis, was performed...
March 2017: La Clinica Terapeutica
https://www.readbyqxmd.com/read/28372501/hyperlactatemia-predicts-citrate-intolerance-with-regional-citrate-anticoagulation-during-continuous-renal-replacement-therapy
#6
Jia-Neng Tan, Sabrina Wong Peixin Haroon, Amartya Mukhopadhyay, Titus Lau, Tanusya M Murali, Jason Phua, Zong-Yao Tan, Nicholas Lee, Horng-Ruey Chua
PURPOSE: We aim to determine whether hyperlactatemia, which suggests multi-organ dysfunction and impaired organic substrate metabolism, may predict intolerance to regional citrate anticoagulation (RCA) during continuous venovenous hemofiltration (CVVH). METHODS: We performed a single-center, retrospective observational study in critically ill patients with acute kidney injury or end-stage renal disease and evaluated the association of peak serum lactate levels with citrate intolerance (CI) during the initial 72 hours of RCA-CVVH, defined by serum total-to-ionized calcium >2...
January 1, 2017: Journal of Intensive Care Medicine
https://www.readbyqxmd.com/read/28367008/lactate-clearance-as-the-predictor-of-outcome-in-pediatric-septic-shock
#7
Richa Choudhary, Sadasivan Sitaraman, Anita Choudhary
CONTEXT: Septic shock can rapidly evolve into multiple system organ failure and death. In the recent years, hyperlactatemia has been found to be a risk factor for mortality in critically ill adults. AIMS: To evaluate the predictive value of lactate clearance and to determine the optimal cut-off value for predicting outcome in children with septic shock. SETTINGS AND DESIGN: A prospective observational study was performed on children with septic shock admitted to pediatric Intensive Care Unit (PICU)...
April 2017: Journal of Emergencies, Trauma, and Shock
https://www.readbyqxmd.com/read/28358631/survival-analysis-of-hypotensive-cats-admitted-to-an-intensive-care-unit-with-or-without-hyperlactatemia-39-cases-2005-2011
#8
Emily K Shea, Stefan C Dombrowski, Deborah C Silverstein
OBJECTIVE To examine the association between blood lactate concentration and survival to hospital discharge in critically ill hypotensive cats. DESIGN Retrospective case series. ANIMALS 39 cats admitted to an intensive care unit of a university veterinary hospital between January 2005 and December 2011 for which blood lactate concentration was recorded ≤ 1 hour before or after a Doppler-derived arterial blood pressure measurement ≤ 90 mm Hg (ie, hypotension) was obtained. PROCEDURES Medical records of each cat were reviewed to assess survival to hospital discharge, illness severity, duration of hospitalization, age, body weight, and PCV...
April 15, 2017: Journal of the American Veterinary Medical Association
https://www.readbyqxmd.com/read/28348141/venous-lactate-ph-and-partial-pressure-of-carbon-dioxide-levels-as-prognostic-indicators-in-110-premature-calves-with-respiratory-distress-syndrome
#9
R Yildiz, U Aydogdu, H Guzelbektes, A Coskun, I Sen
Hyperlactatemia, hypercapnia, low pH and low oxygen saturation (SatO2) are commonly observed in premature calves. These clinical indicators are associated with increased mortality in preterm human newborns with respiratory distress syndrome (RDS). The aim of this study was to investigate the prognostic importance of venous pH, partial pressure of carbon dioxide (pCO2) and lactate level and which parameters are related with mortality in premature calves with RDS. All premature calves (52 male/58 female) were admitted to clinic within 12-24 hours after birth and blood samples were also taken into heparinised plastic syringes from the jugular vein within 30 minutes following admission...
March 27, 2017: Veterinary Record
https://www.readbyqxmd.com/read/28341846/risk-factors-of-post-operative-severe-hyperlactatemia-and-lactic-acidosis-following-laparoscopic-resection-for-pheochromocytoma
#10
Shubin Wu, Weiyun Chen, Le Shen, Li Xu, Afang Zhu, Yuguang Huang
Severe hyperlactatemia (SH)/lactic acidosis (LA) after laparoscopic resection of pheochromocytoma is an infrequently reported complication. The study aims to investigate the incidence of this complication and to determine the clinical risk factors. Patients who underwent laparoscopic resection for pheochromocytoma between 2011 and 2014 at Peking Union Medical College Hospital were enrolled. LA was defined as pH < 7.35, bicarbonate <20 mmol/L, and serum lactate ≥5 mmol/L; SH as lactate ≥5 mmol/L; and moderate hyperlactatemia (MH) as lactate 2...
March 24, 2017: Scientific Reports
https://www.readbyqxmd.com/read/28341190/evolving-cutoff-values-of-hyperlactatemia-and-the-role-of-infection
#11
Xianshi Zhou, Ye Ye, Fang Tian, Fanwei Wu
No abstract text is available yet for this article.
March 15, 2017: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28341187/persistent-hyperlactatemia-high-central-venous-arterial-carbon-dioxide-to-arterial-venous-oxygen-content-ratio-is-associated-with-poor-outcomes-in-early-resuscitation-of-septic-shock
#12
Juandi Zhou, Jia Song, Shijin Gong, Li Li, Haixiang Zhang, Minjia Wang
OBJECTIVE: Several studies reported Pv-aCO2/Ca-vO2 ratio as a surrogate of VCO2/VO2 to detect global tissue hypoxia. The present study aimed to evaluate the prognostic value of Pv-aCO2/Ca-vO2 ratio combined with lactate levels during the early phases of resuscitation in septic shock. METHODS: A retrospective study was conducted in 144 septic shock patients in a 30-bed mixed ICU. A Pv-aCO2/Ca-vO2 ratio>1.4 was considered abnormal. Patients were classified into four predefined groups according to lactate levels and Pv-aCO2/Ca-vO2 ratio after the first 6h of resuscitation...
March 14, 2017: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28320242/early-goal-directed-therapy-for-septic-shock-a-patient-level-meta-analysis
#13
(no author information available yet)
Background After a single-center trial and observational studies suggesting that early, goal-directed therapy (EGDT) reduced mortality from septic shock, three multicenter trials (ProCESS, ARISE, and ProMISe) showed no benefit. This meta-analysis of individual patient data from the three recent trials was designed prospectively to improve statistical power and explore heterogeneity of treatment effect of EGDT. Methods We harmonized entry criteria, intervention protocols, outcomes, resource-use measures, and data collection across the trials and specified all analyses before unblinding...
March 21, 2017: New England Journal of Medicine
https://www.readbyqxmd.com/read/28298660/hyperlactatemia-and-cardiac-surgery
#14
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
#15
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
#16
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
#17
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
#18
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
#19
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
#20
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
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