Show simple item record

dc.contributor.authorVellinga, NAR
dc.contributor.authorBoerma, EC
dc.contributor.authorKoopmans, M
dc.contributor.authorDonati, A
dc.contributor.authorDubin, A
dc.contributor.authorShapiro, NI
dc.contributor.authorPearse, RM
dc.contributor.authorvan der Voort, PHJ
dc.contributor.authorDondorp, AM
dc.contributor.authorBafi, T
dc.contributor.authorFries, M
dc.contributor.authorAkarsu-Ayazoglu, T
dc.contributor.authorPranskunas, A
dc.contributor.authorHollenberg, S
dc.contributor.authorBalestra, G
dc.contributor.authorvan Iterson, M
dc.contributor.authorSadaka, F
dc.contributor.authorMinto, G
dc.contributor.authorAypar, U
dc.contributor.authorHurtado, FJ
dc.contributor.authorMartinelli, G
dc.contributor.authorPayen, D
dc.contributor.authorvan Haren, F
dc.contributor.authorHolley, A
dc.contributor.authorGomez, H
dc.contributor.authorMehta, RL
dc.contributor.authorRodriguez, AH
dc.contributor.authorRuiz, C
dc.contributor.authorCanales, HS
dc.contributor.authorDuranteau, J
dc.contributor.authorSpronk, PE
dc.contributor.authorJhanji, S
dc.contributor.authorHubble, S
dc.contributor.authorChierego, M
dc.contributor.authorJung, C
dc.contributor.authorMartin, Daniel
dc.contributor.authorSorbara, C
dc.contributor.authorBakker, J
dc.contributor.authorInce, C
dc.date.accessioned2020-07-09T13:25:25Z
dc.date.available2020-07-09T13:25:25Z
dc.date.issued2017-10-18
dc.identifier.issn1364-8535
dc.identifier.issn1364-8535
dc.identifier.other255
dc.identifier.urihttp://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.extent255-
dc.format.mediumElectronic
dc.languageen
dc.language.isoen
dc.publisherSpringer Science and Business Media LLC
dc.subjectLactate
dc.subjectMicrocirculation
dc.subjectSDF imaging
dc.subjectIntensive care
dc.subjectPrevalence
dc.titleMildly elevated lactate levels are associated with microcirculatory flow abnormalities and increased mortality: a microSOAP post hoc analysis
dc.typejournal-article
dc.typeJournal Article
dc.typeMulticenter Study
plymouth.author-urlhttps://www.webofscience.com/api/gateway?GWVersion=2&SrcApp=PARTNER_APP&SrcAuth=LinksAMR&KeyUT=WOS:000413122500001&DestLinkType=FullRecord&DestApp=ALL_WOS&UsrCustomerID=11bb513d99f797142bcfeffcc58ea008
plymouth.issue1
plymouth.volume21
plymouth.publication-statusPublished
plymouth.journalCritical Care
dc.identifier.doi10.1186/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.placeEngland
dcterms.dateAccepted2017-09-15
dc.identifier.eissn1364-8535
dc.rights.embargoperiodNot known
rioxxterms.versionofrecord10.1186/s13054-017-1842-7
rioxxterms.licenseref.urihttp://www.rioxx.net/licenses/all-rights-reserved
rioxxterms.licenseref.startdate2017-10-18
rioxxterms.typeJournal Article/Review


Files in this item

Thumbnail
Thumbnail

This item appears in the following Collection(s)

Show simple item record


All items in PEARL are protected by copyright law.
Author manuscripts deposited to comply with open access mandates are made available in accordance with publisher policies. Please cite only the published version using the details provided on the item record or document. In the absence of an open licence (e.g. Creative Commons), permissions for further reuse of content should be sought from the publisher or author.
Theme by 
Atmire NV