Utility of the Early Lactate Area Score as a Prognostic Marker for Septic Shock Patients in the Emergency Department
| Autor: | Youn-Jung Kim, Won Young Kim, Seung Mok Ryoo, Gina Yu, Seung Joon Yoo, Sang Hun Lee, Sung Min Jung, June Sung Kim |
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| Rok vydání: | 2019 |
| Předmět: |
Resuscitation
Surviving Sepsis Campaign business.industry Septic shock lcsh:Medical emergencies. Critical care. Intensive care. First aid CPR/Resuscitation lactic acid Area under the curve lcsh:RC86-88.9 shock Critical Care and Intensive Care Medicine Critical Care Nursing medicine.disease mortality Confidence interval sepsis Sepsis Interquartile range Anesthesia Shock (circulatory) medicine Original Article prognosis medicine.symptom business |
| Zdroj: | Acute and Critical Care Acute and Critical Care, Vol 34, Iss 2, Pp 126-132 (2019) |
| ISSN: | 2586-6060 2586-6052 |
| DOI: | 10.4266/acc.2018.00283 |
| Popis: | Background The current Surviving Sepsis Campaign guidelines recommend the remeasurement of lactate levels if the initial lactate level is elevated; however, the prognostic value of lactate kinetics is limited and inconsistent. We attempted to determine the efficacy of the lactate area score (calculated from repeated lactate measurements during initial resuscitation) as a prognostic marker of septic shock in the emergency department (ED). Methods We performed a retrospective study of adult patients with septic shock in the ED of a single tertiary medical center. Serial lactate levels were measured five times within 12 hours. We also compared the initial lactate level, maximum lactate level, and lactate area score. The lactate area score was defined as the sum of the area under the curve measured at 2, 4, 6, and 12 hours following the initial measurement. Results A total of 362 patients were enrolled in this study, and the overall 28-day mortality was 31.8%. The lactate area score of serial lactate levels as well as the initial (median [interquartile range], 4.9 [3.4 to 10.5]; P=0.003) and maximum (7.3 [4.2 to 13.2]; P |
| Databáze: | OpenAIRE |
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