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lactate clearance

Yao Lu, Han Zhang, Fang Teng, Wen-Jun Xia, Gui-Xiang Sun, Ai-Qing Wen
INTRODUCTION: The Surviving Sepsis Campaign guidelines recommend early goal-directed therapy (EGDT) for the resuscitation of patients with sepsis; however, the recent evidences quickly evolve and convey conflicting results. We performed a meta-analysis to evaluate the effect of EGDT on mortality in adults with severe sepsis and septic shock. METHODS: We searched electronic databases to identify randomized controlled trials that compared EGDT with usual care or lactate-guided therapy in adults with severe sepsis and septic shock...
October 18, 2016: Journal of Intensive Care Medicine
Sarah A Sterling, Michael A Puskarich, Alan E Jones
OBJECTIVE: To describe the effect of liver disease (LD) on lactate clearance during early sepsis resuscitation. METHODS: This is a multicenter randomized clinical trial. An initial lactate >2 mmol/L and subsequent serum lactate measurement within 6 hours were required for inclusion. LD was categorized by two methods: 1) past medical history (PMH) categorized as no LD, mild LD (no Child's score criteria, but PMH of hepatitis B/C), cirrhosis; and 2) measurable liver dysfunction determined by the liver component of the sequential organ failure assessment (L-SOFA) score as no dysfunction (L-SOFA score 0), mild dysfunction (score 1), moderate-severe dysfunction (score 2 to 4)...
December 2015: Clin Exp Emerg Med
Rogério da Hora Passos, Joao Gabriel Rosa Ramos, André Gobatto, Evandro José Bulhões Mendonça, Eva Alves Miranda, Fábio Ricardo Dantas Dutra, Maria Fernanda R Coelho, Andrea C Pedroza, Paulo Benigno Pena Batista, Margarida Maria Dantas Dutra
The aim of the study was to assess the clinical utility of lactate measured at different time points to predict mortality at 48 hours and 28 days in septic patients with acute kidney injury (AKI) requiring continuous renal replacement therapy (CRRT).Consecutive critically ill patients with septic AKI requiring CRRT were prospectively studied. Variables were collected at initiation of CRRT and 24 hours later.In total, 186 patients were analyzed. Overall mortality at 48 hours was 28% and at 28 days was 69%...
October 2016: Medicine (Baltimore)
Chun-Chieh Yang, Khee-Siang Chan, Kuei-Ling Tseng, Shih-Feng Weng
Lactic acidosis is common in critical care; by contrast, a subtype called alcohol-associated lactic acidosis (AALA) is rarely encountered. The primary purpose of this study was to determine the prognosis of AALA in critically ill patients and the second aim was to determine whether the survival was associated to the peak blood lactate concentration. An 8-year retrospective analysis of adult patients admitted to the intensive care unit (ICU) with AALA between January 2007 and December 2014 was considered in a tertiary care hospital...
October 17, 2016: Scientific Reports
S E Dekker, H-M de Vries, W D Lubbers, P M van de Ven, E J Toor, F W Bloemers, L M G Geeraedts, P Schober, C Boer
PURPOSE: Despite the availability of different lactate clearance (LC) metrics for clinical use, it remains unknown which metric is superior as a clinical predictor for outcome, particularly in trauma patients. This retrospective study compared four previously described metrics of LC and examined the association between LC and outcome in trauma patients. METHODS: Lactate values of trauma patients admitted to a level I trauma center between 2010 and 2013 were retrieved from patient records...
October 13, 2016: European Journal of Trauma and Emergency Surgery: Official Publication of the European Trauma Society
Christine Sievert, Henning Richter, Katrin Beckmann, Patrick R Kircher, Ines Carrera
In vivo diagnosis of tick-borne encephalitis is difficult due to high seroprevalence and rapid viral clearance, limiting detection of antibodies in blood and cerebrospinal fluid. Magnetic resonance imaging (MRI) characteristics of tick-borne encephalitis have been reported, however MRI studies can also be negative despite the presence of neurologic signs. Magnetic resonance spectroscopy ((1) H MRS) is an imaging method that provides additional information about the metabolic characteristics of brain tissues...
October 7, 2016: Veterinary Radiology & Ultrasound
Feng Zhou, Peichen Zhang, Xiaoxi Chen, Jingyi Yan, Jiangao Yao, Zhen Yu, Xiaolei Chen
Ginsenoside Rb1 (GRb1), which is one of the main ingredients derived from Panax ginseng, has been widely used to treat various gastrointestinal disorders. The present study aimed to determine whether GRb1 was able to prevent intestinal mucosal barrier damage in rats following peritoneal air exposure for 3 h. GRb1 (5, 10, and 20 mg/kg) was orally administrated via gavage four times prior to and following surgery. Blood and terminal ileum were sampled 24 h following surgery. Levels of serum D-lactate (D-LA) were detected using an enzyme-linked immunosorbent assay kit...
October 2016: Experimental and Therapeutic Medicine
Luca Visconti, Valeria Cernaro, Domenico Ferrara, Giuseppe Costantino, Carmela Aloisi, Luisa Amico, Valeria Chirico, Domenico Santoro, Alberto Noto, Antonio David, Michele Buemi, Antonio Lacquaniti
Metformin, belonging to a class of drugs called biguanides, is the recommended first-line treatment for overweight patients with type 2 diabetes mellitus. It has multiple mechanisms of action, such as reduction of gluconeogenesis, increases peripheral uptake of glucose, and decreases fatty acid oxidation. However, a potential serious complication, defined metformin-associated lactic acidosis (MALA), is related to increased plasma lactate levels, linked to an elevated plasma metformin concentrations and/or a coexistent condition altering lactate production or clearance...
August 10, 2016: Renal Failure
Fredrik Iredahl, Alexandra Högstedt, Joakim Henricson, Folke Sjöberg, Erik Tesselaar, Simon Farnebo
Insulin causes capillary recruitment in muscle and adipose tissue, but the metabolic and microvascular effects of insulin in the skin have not been studied in detail. The aim of this study was to measure glucose metabolism and microvascular blood flow in the skin during local insulin delivery and after an oral glucose load using intracutaneous microdialysis and laser speckle contrast imaging (LSCI). Within 15 minutes of local insulin delivery, microvascular blood flow in the skin increased (urea clearance: p=0...
September 28, 2016: Microcirculation: the Official Journal of the Microcirculatory Society, Inc
Abdullah K Al-Hwiesh, Ibrahiem S Abdul-Rahman, Abdul-Salam Noor, Mohammed A Nasr-El-Deen, Abdalla Abdelrahman, Tamer S El-Salamony, Fahd A Al-Muhanna, Khalid M Al-Otaibi, Nehad Al-Audah
♦ Objective: Metformin continues to be the safest and most widely used antidiabetic drug. In spite of its well-known benefits; metformin use in end-stage renal disease (ESRD) patients is still restricted. Little has been reported about the effect of peritoneal dialysis (PD) on metformin clearance and the phantom of lactic acidosis deprives ESRD patients from metformin therapeutic advantages. Peritoneal dialysis is probably a safeguard against lactic acidosis, and it is likely that using this drug would be feasible in this group of patients...
September 28, 2016: Peritoneal Dialysis International: Journal of the International Society for Peritoneal Dialysis
F-C Tang, C-C Chan
BACKGROUND/OBJECTIVES: Branched-chain amino acids (BCAAs) and purine nucleotide cycle (PNC) are both associated with energy metabolism. The purpose of this study was to explore the influences of BCAA supplementation on the PNC activity of male athletes in response to a bout of endurance running exercise. SUBJECTS/METHODS: Twelve male athletes (20.3±1.4 years) participated in the study. Each of the athletes received 12 g of a BCAA supplement (leucine 54%, isoleucine 19% and valine 27%) per day during the study...
September 28, 2016: European Journal of Clinical Nutrition
J X Zhang, M Yin, X M Chen, C Li, D W Wu, S F Ding, B F Du, H P Guo, W D Qin, H N Yang, H Wang
Objective: To investigate the predictive value of early lactate area for mortality in elderly patients with septic shock. Methods: From January 2012 to December 2013, a prospective study was conducted in the Department of Critical Care Medicine, Qilu Hospital of Shandong University. A total of 115 septic shock patients with age ≥65 years were included in the study. Serum lactate was measured every 6 hours, the lactate indicators, including early lactate area, APACHE Ⅱ score etc were recorded. Results: The overall 28-day mortality rate was 67...
September 6, 2016: Zhonghua Yi Xue za Zhi [Chinese medical journal]
Manuela Bonizzoli, Chiara Lazzeri, Giovanni Cianchi, Maria Boddi, Morena Cozzolino, Simona Di Valvasone, Paolo Terenzi, Stefano Batacchi, Marco Chiostri, Adriano Peris
BACKGROUND: Serial lactate measurements over time or lactate clearance has been reported to be clinically reliable for risk stratification in different pathologic conditions ranging from sepsis to trauma, but no data are so far available on the behavior of lactate during venovenous extracorporeal membrane oxygenation (VV-ECMO) support in refractory adult acute respiratory distress syndrome (ARDS). METHODS: We assessed lactate values during VV-ECMO support and the prognostic role of lactate clearance at 6, 24, and 72 hours after ECMO start in 126 consecutive patients with refractory ARDS treated with VV-ECMO...
September 22, 2016: Annals of Thoracic Surgery
Taylor S Howard, Brian T Kalish, Daniel Wigmore, Meena Nathan, Thomas J Kulik, Aditya K Kaza, Kathryn Williams, Ravi R Thiagarajan
OBJECTIVES: There is a paucity of data regarding the impact of extracorporeal membrane oxygenation support, adequacy of surgical repair, and timing of intervention for residual structural lesions in neonates cannulated to extracorporeal membrane oxygenation after cardiac surgery. Our goal was to determine how these factors were associated with survival. DESIGN: Retrospective study. SETTING: Cardiovascular ICU. SUBJECTS: Neonates (≤ 28 d old) with congenital heart disease cannulated to extracorporeal membrane oxygenation after cardiac surgery during 2006-2013...
September 19, 2016: Pediatric Critical Care Medicine
J Moritz Kaths, Jun Yu Cen, Yi Min Chun, Juan Echeverri, Ivan Linares, Sujani Ganesh, Paul Yip, Rohan John, Darius Bagli, Istvan Mucsi, Anand Ghanekar, David Grant, Lisa A Robinson, Markus Selzner
Hypothermic preservation is known to cause renal graft injury, especially in donation after circulatory death (DCD) kidney transplantation. We investigated the impact of cold storage (SCS) vs. short periods of normothermic ex vivo kidney perfusion (NEVKP) after SCS vs. prolonged, continuous NEVKP with near avoidance of SCS on kidney function after transplantation. Following 30 minutes of warm ischemia, kidneys were removed from 30kg Yorkshire pigs and preserved for 16h with: A) 16h SCS, B) 15h SCS + 1h NEVKP, C) 8h SCS + 8h NEVKP, D) 16h NEVKP...
September 20, 2016: American Journal of Transplantation
Ashok Choudhury, Chandan Kumar Kedarisetty, Chitranshu Vashishtha, Deepak Saini, Sachin Kumar, Rakhi Maiwall, Manoj Kumar Sharma, Ajeet Singh Bhadoria, Guresh Kumar, Yogendra Kumar Joshi, Shiv Kumar Sarin
BACKGROUND AND AIMS: The choice of vasopressor for treating cirrhosis with septic shock is unclear. While noradrenaline in general is the preferred vasopressor, terlipressin improves microcirculation in addition to vasopressor action in non-cirrhotics. We compared the efficacy and safety of noradrenaline and terlipressin in cirrhotics with septic shock. PATIENTS AND METHODS: Cirrhotics with septic shock underwent open label randomization to receive either terlipressin (n=42)or noradrenaline (n=42) infusion at a titrated dose...
September 16, 2016: Liver International: Official Journal of the International Association for the Study of the Liver
Nasreen Akhtar, Weiping Li, Aleksander Mironov, Charles H Streuli
An important feature of the mammary gland is its ability to undergo repeated morphological changes during each reproductive cycle with profound tissue expansion in pregnancy and regression in involution. However, the mechanisms that determine the tissue's cyclic regenerative capacity remain elusive. We have now discovered that Cre-Lox ablation of Rac1 in mammary epithelia causes gross enlargement of the epithelial tree and defective alveolar regeneration in a second pregnancy. Architectural defects arise because loss of Rac1 disrupts clearance in involution following the first lactation...
September 12, 2016: Developmental Cell
Rebecca D Powell, Donna A Goodenow, Hannah V Mixer, Iain H Mckillop, Susan L Evans
BACKGROUND: Hemorrhagic shock and reperfusion (HSR) injury leads to a cascade of reactive oxygen species (ROS) production and mitochondrial dysfunction, which results in energy failure, cell death and multiple organ dysfunction. Cytochrome c (cyt c) is the final electron carrier in the mitochondrial electron transport chain providing the electrochemical force for ATP production. We sought to determine whether exogenous cyt c administration would improve parameters of organ dysfunction and/or mitochondrial stability in a rat model of HSR...
September 3, 2016: Journal of Trauma and Acute Care Surgery
D H El-Kashef, A E El-Kenawi, G M Suddek, H A Salem
Cyclosporine-A (CsA) is an immunosuppressive drug which has been used to prevent rejection after organ transplantation and to treat certain autoimmune diseases. However, its therapeutic use is limited by nephrotoxicity. In this study, the modulator effect of allicin on the oxidative nephrotoxicity of CsA in rats was investigated. Furthermore, the effect of allicin on CsA-induced hypersensitivity of urinary bladder rings to acetylcholine (ACh) was estimated. Rats were divided into three groups, control, CsA (15 mg/kg, subcutaneously), and CsA/allicin (50 mg/kg, orally)...
September 5, 2016: Human & Experimental Toxicology
Richard Mwaiswelo, Billy Ngasala, Irina Jovel, Berit Aydin-Schmidt, Roland Gosling, Zul Premji, Bruno Mmbando, Anders Björkman, Andreas Mårtensson
BACKGROUND: The World Health Organization (WHO) recently recommended the addition of a single low-dose of the gametocytocidal drug primaquine (PQ) to artemisinin-based combination therapy (ACT) in low transmission settings as a component of pre-elimination or elimination programmes. However, it is unclear whether that influences the ACT cure rate. The study assessed treatment outcome of artemether-lumefantrine (AL) plus a single PQ dose (0.25 mg/kg) versus standard AL regimen for treatment of acute uncomplicated Plasmodium falciparum malaria in Tanzania...
2016: Malaria Journal
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