Mildly elevated lactate levels are associated with microcirculatory flow abnormalities and increased mortality: a microSOAP post hoc analysis
dc.contributor.author | Vellinga, NAR | |
dc.contributor.author | Boerma, EC | |
dc.contributor.author | Koopmans, M | |
dc.contributor.author | Donati, A | |
dc.contributor.author | Dubin, A | |
dc.contributor.author | Shapiro, NI | |
dc.contributor.author | Pearse, RM | |
dc.contributor.author | van der Voort, PHJ | |
dc.contributor.author | Dondorp, AM | |
dc.contributor.author | Bafi, T | |
dc.contributor.author | Fries, M | |
dc.contributor.author | Akarsu-Ayazoglu, T | |
dc.contributor.author | Pranskunas, A | |
dc.contributor.author | Hollenberg, S | |
dc.contributor.author | Balestra, G | |
dc.contributor.author | van Iterson, M | |
dc.contributor.author | Sadaka, F | |
dc.contributor.author | Minto, G | |
dc.contributor.author | Aypar, U | |
dc.contributor.author | Hurtado, FJ | |
dc.contributor.author | Martinelli, G | |
dc.contributor.author | Payen, D | |
dc.contributor.author | van Haren, F | |
dc.contributor.author | Holley, A | |
dc.contributor.author | Gomez, H | |
dc.contributor.author | Mehta, RL | |
dc.contributor.author | Rodriguez, AH | |
dc.contributor.author | Ruiz, C | |
dc.contributor.author | Canales, HS | |
dc.contributor.author | Duranteau, J | |
dc.contributor.author | Spronk, PE | |
dc.contributor.author | Jhanji, S | |
dc.contributor.author | Hubble, S | |
dc.contributor.author | Chierego, M | |
dc.contributor.author | Jung, C | |
dc.contributor.author | Martin, Daniel | |
dc.contributor.author | Sorbara, C | |
dc.contributor.author | Bakker, J | |
dc.contributor.author | Ince, C | |
dc.date.accessioned | 2020-07-09T13:25:25Z | |
dc.date.available | 2020-07-09T13:25:25Z | |
dc.date.issued | 2017-10-18 | |
dc.identifier.issn | 1364-8535 | |
dc.identifier.issn | 1364-8535 | |
dc.identifier.other | 255 | |
dc.identifier.uri | http://hdl.handle.net/10026.1/15939 | |
dc.description.abstract |
BACKGROUND: Mildly elevated lactate levels (i.e., 1-2 mmol/L) are increasingly recognized as a prognostic finding in critically ill patients. One of several possible underlying mechanisms, microcirculatory dysfunction, can be assessed at the bedside using sublingual direct in vivo microscopy. We aimed to evaluate the association between relative hyperlactatemia, microcirculatory flow, and outcome. METHODS: This study was a predefined subanalysis of a multicenter international point prevalence study on microcirculatory flow abnormalities, the Microcirculatory Shock Occurrence in Acutely ill Patients (microSOAP). Microcirculatory flow abnormalities were assessed with sidestream dark-field imaging. Abnormal microcirculatory flow was defined as a microvascular flow index (MFI) < 2.6. MFI is a semiquantitative score ranging from 0 (no flow) to 3 (continuous flow). Associations between microcirculatory flow abnormalities, single-spot lactate measurements, and outcome were analyzed. RESULTS: In 338 of 501 patients, lactate levels were available. For this substudy, all 257 patients with lactate levels ≤ 2 mmol/L (median [IQR] 1.04 [0.80-1.40] mmol/L) were included. Crude ICU mortality increased with each lactate quartile. In a multivariable analysis, a lactate level > 1.5 mmol/L was independently associated with a MFI < 2.6 (OR 2.5, 95% CI 1.1-5.7, P = 0.027). CONCLUSIONS: In a heterogeneous ICU population, a single-spot mildly elevated lactate level (even within the reference range) was independently associated with increased mortality and microvascular flow abnormalities. In vivo microscopy of the microcirculation may be helpful in discriminating between flow- and non-flow-related causes of mildly elevated lactate levels. TRIAL REGISTRATION: ClinicalTrials.gov, NCT01179243 . Registered on August 3, 2010. | |
dc.format.extent | 255- | |
dc.format.medium | Electronic | |
dc.language | en | |
dc.language.iso | en | |
dc.publisher | Springer Science and Business Media LLC | |
dc.subject | Lactate | |
dc.subject | Microcirculation | |
dc.subject | SDF imaging | |
dc.subject | Intensive care | |
dc.subject | Prevalence | |
dc.title | Mildly elevated lactate levels are associated with microcirculatory flow abnormalities and increased mortality: a microSOAP post hoc analysis | |
dc.type | journal-article | |
dc.type | Journal Article | |
dc.type | Multicenter Study | |
plymouth.author-url | https://www.webofscience.com/api/gateway?GWVersion=2&SrcApp=PARTNER_APP&SrcAuth=LinksAMR&KeyUT=WOS:000413122500001&DestLinkType=FullRecord&DestApp=ALL_WOS&UsrCustomerID=11bb513d99f797142bcfeffcc58ea008 | |
plymouth.issue | 1 | |
plymouth.volume | 21 | |
plymouth.publication-status | Published | |
plymouth.journal | Critical Care | |
dc.identifier.doi | 10.1186/s13054-017-1842-7 | |
plymouth.organisational-group | /Plymouth | |
plymouth.organisational-group | /Plymouth/Faculty of Health | |
plymouth.organisational-group | /Plymouth/Faculty of Health/Peninsula Medical School | |
plymouth.organisational-group | /Plymouth/REF 2021 Researchers by UoA | |
plymouth.organisational-group | /Plymouth/REF 2021 Researchers by UoA/UoA01 Clinical Medicine | |
plymouth.organisational-group | /Plymouth/Users by role | |
plymouth.organisational-group | /Plymouth/Users by role/Academics | |
dc.publisher.place | England | |
dcterms.dateAccepted | 2017-09-15 | |
dc.identifier.eissn | 1364-8535 | |
dc.rights.embargoperiod | Not known | |
rioxxterms.versionofrecord | 10.1186/s13054-017-1842-7 | |
rioxxterms.licenseref.uri | http://www.rioxx.net/licenses/all-rights-reserved | |
rioxxterms.licenseref.startdate | 2017-10-18 | |
rioxxterms.type | Journal Article/Review |