Vasopressin Administration Is Associated With Rising Serum Lactate Levels in Patients With Sepsis.

Autor:	Severson KA; Department of Chemical Engineering, Massachusetts Institute of Technology, Cambridge, MA, USA., Ritter-Cox L; Department of Anesthesia, Critical Care, and Pain Medicine, Beth Israel Deaconess Medical Center, Boston, MA, USA., Raffa JD; Institute for Medical Engineering and Science, Massachusetts Institute of Technology, Cambridge, MA, USA., Celi LA; Institute for Medical Engineering and Science, Massachusetts Institute of Technology, Cambridge, MA, USA.; Division of Pulmonary, Critical Care and Sleep Medicine, Beth Israel Deaconess Medical Center, Boston, MA, USA., Gordon WJ; Department of Medicine, Massachusetts General Hospital, Boston, MA, USA.; Brigham and Women's Hospital, Boston, MA, USA.; Harvard Medical School, Boston, MA, USA.
Jazyk:	angličtina
Zdroj:	Journal of intensive care medicine [J Intensive Care Med] 2020 Sep; Vol. 35 (9), pp. 881-888. Date of Electronic Publication: 2018 Aug 21.
DOI:	10.1177/0885066618794925
Abstrakt:	Background: Vasopressin is used in conjunction with norepinephrine during treatment of patients with septic shock. Serum lactate is often used in monitoring of patients with sepsis; however, its importance as a therapeutic target is unclear. The objective of this study is to examine the relationship of vasopressin use on serum lactate levels in patients with sepsis. Methods: This study uses electronic heath records available via the Medical Information Mart for Intensive Care III. Patients were required to have a serum lactate monitoring during the intensive care unit (ICU) stay. The treatment was the administration of vasopressin between hours 3 and 18 of the ICU stay. Analysis was performed using a matched design. Results: Patients receiving vasopressin were more likely to have their serum lactate levels rise when compared to matched patients who did not receive vasopressin (odds ratio: 6.6; 95% confidence interval: 3.0-14.6, P < .001). Patients who received vasopressin had a median increase in serum lactate of 0.3 mmol/L, while patients who did not receive vasopressin had a median decrease in serum lactate of 0.7 mmol/L ( P < .001). There was no statistically significant difference between the control and treated groups' lactate trajectories prior to possible administration of vasopressin ( P = .15). The results did not change significantly when norepinephrine initiation was used as the index time. Conclusions: In patients with sepsis, the administration of vasopressin was associated with a statistically significant difference in lactate change over the course of 24 hours when compared to matched patients who did not receive vasopressin.
Databáze:	MEDLINE
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