The value of blood lactate kinetics in critically ill patients: a systematic review

Jean-Louis Vincent, Amanda Quintairos E Silva, Lúcio Couto Jr, Fabio S Taccone, Jean-Louis Vincent, Amanda Quintairos E Silva, Lúcio Couto Jr, Fabio S Taccone

Abstract

Background: The time course of blood lactate levels could be helpful to assess a patient's response to therapy. Although the focus of published studies has been largely on septic patients, many other studies have reported serial blood lactate levels in different groups of acutely ill patients.

Methods: We performed a systematic search of PubMed, Science Direct, and Embase until the end of February 2016 plus reference lists of relevant publications. We selected all observational and interventional studies that evaluated the capacity of serial blood lactate concentrations to predict outcome. There was no restriction based on language. We excluded studies in pediatric populations, experimental studies, and studies that did not report changes in lactate values or all-cause mortality rates. We separated studies according to the type of patients included. We collected data on the number of patients, timing of lactate measurements, minimum lactate level needed for inclusion if present, and suggested time interval for predictive use.

Results: A total of 96 studies met our criteria: 14 in general ICU populations, five in general surgical ICU populations, five in patients post cardiac surgery, 14 in trauma patients, 39 in patients with sepsis, four in patients with cardiogenic shock, eight in patients after cardiac arrest, three in patients with respiratory failure, and four in other conditions. A decrease in lactate levels over time was consistently associated with lower mortality rates in all subgroups of patients. Most studies reported changes over 6, 12 or 24 hrs, fewer used shorter time intervals. Lactate kinetics did not appear very different in patients with sepsis and other types of patients. A few studies suggested that therapy could be guided by these measurements.

Conclusions: The observation of a better outcome associated with decreasing blood lactate concentrations was consistent throughout the clinical studies, and was not limited to septic patients. In all groups, the changes are relatively slow, so that lactate measurements every 1-2 hrs are probably sufficient in most acute conditions. The value of lactate kinetics appears to be valid regardless of the initial value.

Figures

Fig. 1
Fig. 1
Schematic showing some of the possible evolutions of blood lactate levels over time: decreasing (1), remaining stable (2), or increasing (3). Dashed lines represent an unfavorable course and suggest the need for treatment to be reviewed, if this has not already been done, because the current management is likely ineffective
Fig. 2
Fig. 2
Prisma diagram

References

    1. Broder G, Weil MH. Excess lactate: an index of reversibility of shock in human patients. Science. 1964;143:1457–9. doi: 10.1126/science.143.3613.1457.
    1. Weil MH, Afifi AA. Experimental and clinical studies on lactate and pyruvate as indicators of the severity of acute circulatory failure (shock) Circulation. 1970;41:989–1001. doi: 10.1161/01.CIR.41.6.989.
    1. Peretz DI, McGregor M, Dossetor JB. Lactic acidosis: a clinically significant aspect of shock. Can Med Assoc J. 1964;90:673–5.
    1. Vincent JL, De Backer D. Circulatory shock. N Engl J Med. 2013;369:1726–34. doi: 10.1056/NEJMra1208943.
    1. Levy B. Lactate and shock state: the metabolic view. Curr Opin Crit Care. 2006;12:315–21. doi: 10.1097/01.ccx.0000235208.77450.15.
    1. Nichol AD, Egi M, Pettila V, Bellomo R, French C, Hart G, et al. Relative hyperlactatemia and hospital mortality in critically ill patients: a retrospective multi-centre study. Crit Care. 2010;14:R25. doi: 10.1186/cc8888.
    1. Singer M, Deutschman CS, Seymour CW, Shankar-Hari M, Annane D, Bauer M, et al. The Third International Consensus Definitions for Sepsis and Septic Shock (Sepsis-3) JAMA. 2016;315:801–10. doi: 10.1001/jama.2016.0287.
    1. Kraut JA, Madias NE. Lactic acidosis. N Engl J Med. 2014;371:2309–19. doi: 10.1056/NEJMra1309483.
    1. Cecconi M, De Backer D, Antonelli M, Beale R, Bakker J, Hofer C, et al. Consensus on circulatory shock and hemodynamic monitoring. Task force of the European Society of Intensive Care Medicine. Intensive Care Med. 2014;40:1795–815. doi: 10.1007/s00134-014-3525-z.
    1. Nichol A, Bailey M, Egi M, Pettila V, French C, Stachowski E, et al. Dynamic lactate indices as predictors of outcome in critically ill patients. Crit Care. 2011;15:R242. doi: 10.1186/cc10497.
    1. Haas SA, Lange T, Saugel B, Petzoldt M, Fuhrmann V, Metschke M, et al. Severe hyperlactatemia, lactate clearance and mortality in unselected critically ill patients. Intensive Care Med. 2016;42:202–10. doi: 10.1007/s00134-015-4127-0.
    1. Vincent JL, Dufaye P, Berre J, Leeman M, Degaute JP, Kahn RJ. Serial lactate determinations during circulatory shock. Crit Care Med. 1983;11:449–51. doi: 10.1097/00003246-198306000-00012.
    1. Orringer CE, Eustace JC, Wunsch CD, Gardner LB. Natural history of lactic acidosis after grand-mal seizures. A model for the study of an anion-gap acidosis not associated with hyperkalemia. N Engl J Med. 1977;297:796–9. doi: 10.1056/NEJM197710132971502.
    1. Polonen P, Ruokonen E, Hippelainen M, Poyhonen M, Takala J. A prospective, randomized study of goal-oriented hemodynamic therapy in cardiac surgical patients. Anesth Analg. 2000;90:1052–9. doi: 10.1097/00000539-200005000-00010.
    1. Jansen TC, van Bommel J, Schoonderbeek FJ, Sleeswijk Visser SJ, van der Klooster JM, Lima AP, et al. Early lactate-guided therapy in intensive care unit patients: a multicenter, open-label, randomized controlled trial. Am J Respir Crit Care Med. 2010;182:752–61. doi: 10.1164/rccm.200912-1918OC.
    1. Jones AE, Shapiro NI, Trzeciak S, Arnold RC, Claremont HA, Kline JA. Lactate clearance vs central venous oxygen saturation as goals of early sepsis therapy: a randomized clinical trial. JAMA. 2010;303:739–46. doi: 10.1001/jama.2010.158.
    1. Dettmer M, Holthaus CV, Fuller BM. The impact of serial lactate monitoring on emergency department resuscitation interventions and clinical outcomes in severe sepsis and septic shock: an observational cohort study. Shock. 2015;43:55–61. doi: 10.1097/SHK.0000000000000260.
    1. Nguyen HB, Kuan WS, Batech M, Shrikhande P, Mahadevan M, Li CH, et al. Outcome effectiveness of the severe sepsis resuscitation bundle with addition of lactate clearance as a bundle item: a multi-national evaluation. Crit Care. 2011;15:R229. doi: 10.1186/cc10469.
    1. Vincent JL. Serial blood lactate levels reflect both lactate production and clearance. Crit Care Med. 2015;43:e209. doi: 10.1097/CCM.0000000000000906.
    1. Vincent JL. Lactic acidosis. N Engl J Med. 2015;372:1077–8.
    1. Levraut J, Ciebiera JP, Chave S, Rabary O, Jambou P, Carles M, et al. Mild hyperlactatemia in stable septic patients is due to impaired lactate clearance rather than overproduction. Am J Respir Crit Care Med. 1998;157:1021–6. doi: 10.1164/ajrccm.157.4.9705037.
    1. Revelly JP, Tappy L, Martinez A, Bollmann M, Cayeux MC, Berger MM, et al. Lactate and glucose metabolism in severe sepsis and cardiogenic shock. Crit Care Med. 2005;33:2235–40. doi: 10.1097/01.CCM.0000181525.99295.8F.
    1. Cowan BN, Burns HJ, Boyle P, Ledingham IM. The relative prognostic value of lactate and haemodynamic measurements in early shock. Anaesthesia. 1984;39:750–5. doi: 10.1111/j.1365-2044.1984.tb06516.x.
    1. Suistomaa M, Ruokonen E, Kari A, Takala J. Time-pattern of lactate and lactate to pyruvate ratio in the first 24 hrs of intensive care emergency admissions. Shock. 2000;14:8–12. doi: 10.1097/00024382-200014010-00002.
    1. Wang H, Wu DW, Chen XM, Li C, Ding SF, Zhai Q, et al. Relationship between blood lactic level, lactic clearance, duration of lacticemia and prognosis of critically ill patients in intensive care unit. Zhongguo Wei Zhong Bing Ji Jiu Yi Xue. 2009;21:357–60.
    1. Jansen TC, van Bommel J, Mulder PG, Lima AP, van der Hoven B, Rommes JH, et al. Prognostic value of blood lactate levels: does the clinical diagnosis at admission matter? J Trauma. 2009;66:377–85. doi: 10.1097/TA.0b013e3181648e2f.
    1. Krishna U, Joshi SP, Modh M. An evaluation of serial blood lactate measurement as an early predictor of shock and its outcome in patients of trauma or sepsis. Indian J Crit Care Med. 2009;13:66–73. doi: 10.4103/0972-5229.56051.
    1. Soliman HM, Vincent JL. Prognostic value of admission serum lactate concentrations in intensive care unit patients. Acta Clin Belg. 2010;65:176–81. doi: 10.1179/acb.2010.037.
    1. van Beest PA, Brander L, Jansen SP, Rommes JH, Kuiper MA, Spronk PE. Cumulative lactate and hospital mortality in ICU patients. Ann Intensive Care. 2013;3:6. doi: 10.1186/2110-5820-3-6.
    1. Zhang Z, Chen K, Ni H, Fan H. Predictive value of lactate in unselected critically ill patients: an analysis using fractional polynomials. J Thorac Dis. 2014;6:995–1003.
    1. Jansen TC, van Bommel J, Mulder PG, Rommes JH, Schieveld SJ, Bakker J. The prognostic value of blood lactate levels relative to that of vital signs in the pre-hospital setting: a pilot study. Crit Care. 2008;12:R160. doi: 10.1186/cc7159.
    1. McNelis J, Marini CP, Jurkiewicz A, Szomstein S, Simms HH, Ritter G, et al. Prolonged lactate clearance is associated with increased mortality in the surgical intensive care unit. Am J Surg. 2001;182:481–5. doi: 10.1016/S0002-9610(01)00755-3.
    1. Husain FA, Martin MJ, Mullenix PS, Steele SR, Elliott DC. Serum lactate and base deficit as predictors of mortality and morbidity. Am J Surg. 2003;185:485–91. doi: 10.1016/S0002-9610(03)00044-8.
    1. Meregalli A, Oliveira RP, Friedman G. Occult hypoperfusion is associated with increased mortality in hemodynamically stable, high-risk, surgical patients. Crit Care. 2004;8:R60–5. doi: 10.1186/cc2423.
    1. Cardinal Fernandez PA, Olano E, Acosta C, Bertullo H, Albornoz H, Bagnulo H. Prognostic value of lactate clearance in the first 6 hrs of intensive medicine course. Med Intensiva. 2009;33:166–70. doi: 10.1016/S0210-5691(09)71212-4.
    1. Ibrahim WA, Ahmed AS. Serial estimations of blood lactate predict postoperative outcome in cancer patients undergoing head and neck surgeries. Egyptian J Anaesth. 2013;29:149–54. doi: 10.1016/j.egja.2012.10.003.
    1. Lindsay AJ, Xu M, Sessler DI, Blackstone EH, Bashr CA. Lactate clearance time and concentration linked to morbidity and death in cardiac surgical patients. Ann Thorac Surg. 2013;95:486–92. doi: 10.1016/j.athoracsur.2012.07.020.
    1. Hajjar LA, Almeida JP, Fukushima JT, Rhodes A, Vincent JL, Osawa EA, et al. High lactate levels are predictors of major complications after cardiac surgery. J Thorac Cardiovasc Surg. 2013;146:455–60. doi: 10.1016/j.jtcvs.2013.02.003.
    1. Park SJ, Kim SP, Kim JB, Jung SH, Choo SJ, Chung CH, et al. Blood lactate level during extracorporeal life support as a surrogate marker for survival. J Thorac Cardiovasc Surg. 2014;148:714–20. doi: 10.1016/j.jtcvs.2014.02.078.
    1. Lopez-Delgado JC, Esteve F, Javierre C, Torrado H, Rodriguez-Castro D, Carrio ML, et al. Evaluation of serial arterial lactate levels as a predictor of hospital and long-term mortality in patients after cardiac surgery. J Cardiothorac Vasc Anesth. 2015;29:1441–53. doi: 10.1053/j.jvca.2015.04.024.
    1. Li CL, Wang H, Jia M, Ma N, Meng X, Hou XT. The early dynamic behavior of lactate is linked to mortality in postcardiotomy patients with extracorporeal membrane oxygenation support: A retrospective observational study. J Thorac Cardiovasc Surg. 2015;149:1445–50. doi: 10.1016/j.jtcvs.2014.11.052.
    1. Abramson D, Scalea TM, Hitchcock R, Trooskin SZ, Henry SM, Greenspan J. Lactate clearance and survival following injury. J Trauma. 1993;35:584–8. doi: 10.1097/00005373-199310000-00014.
    1. Manikis P, Jankowski S, Zhang H, Kahn RJ, Vincent JL. Correlation of serial blood lactate levels to organ failure and mortality after trauma. Am J Emerg Med. 1995;13:619–22. doi: 10.1016/0735-6757(95)90043-8.
    1. Holm C, Melcer B, Horbrand F, Worl HH, von Donnersmarck GH, Muhlbauer W. Haemodynamic and oxygen transport responses in survivors and non-survivors following thermal injury. Burns. 2000;26:25–33. doi: 10.1016/S0305-4179(99)00095-9.
    1. Cerovic O, Golubovic V, Spec-Marn A, Kremzar B, Vidmar G. Relationship between injury severity and lactate levels in severely injured patients. Intensive Care Med. 2003;29:1300–5. doi: 10.1007/s00134-003-1753-8.
    1. Kamolz LP, Andel H, Schramm W, Meissl G, Herndon DN, Frey M. Lactate: early predictor of morbidity and mortality in patients with severe burns. Burns. 2005;31:986–90. doi: 10.1016/j.burns.2005.06.019.
    1. Billeter A, Turina M, Seifert B, Mica L, Stocker R, Keel M. Early serum procalcitonin, interleukin-6, and 24-hr lactate clearance: useful indicators of septic infections in severely traumatized patients. World J Surg. 2009;33:558–66. doi: 10.1007/s00268-008-9896-y.
    1. Regnier MA, Raux M, Le MY, Asencio Y, Gaillard J, Devilliers C, et al. Prognostic significance of blood lactate and lactate clearance in trauma patients. Anesthesiology. 2012;117:1276–88. doi: 10.1097/ALN.0b013e318273349d.
    1. Dubendorfer C, Billeter AT, Seifert B, Keel M, Turina M. Serial lactate and admission SOFA scores in trauma: an analysis of predictive value in 724 patients with and without traumatic brain injury. Eur J Trauma Emerg Surg. 2013;39:25–34. doi: 10.1007/s00068-012-0212-z.
    1. Odom SR, Howell MD, Silva GS, Nielsen VM, Gupta A, Shapiro NI, et al. Lactate clearance as a predictor of mortality in trauma patients. J Trauma Acute Care Surg. 2013;74:999–1004. doi: 10.1097/TA.0b013e3182858a3e.
    1. Heinonen E, Hardcastle TC, Barle H, Muckart DJ. Lactate clearance predicts outcome after major trauma. Afr J Emerg Med. 2014;4:61–5. doi: 10.1016/j.afjem.2013.11.006.
    1. Freitas AD, Franzon O. Lactate as predictor of mortality in polytrauma. Arq Bras Cir Dig. 2015;28:163–6. doi: 10.1590/S0102-67202015000300004.
    1. Dezman ZD, Comer AC, Smith GS, Narayan M, Scalea TM, Hirshon JM. Failure to clear elevated lactate predicts 24-hr mortality in trauma patients. J Trauma Acute Care Surg. 2015;79:580–5. doi: 10.1097/TA.0000000000000810.
    1. Roumen RM, Redl H, Schlag G, Sandtner W, Koller W, Goris RJ. Scoring systems and blood lactate concentrations in relation to the development of adult respiratory distress syndrome and multiple organ failure in severely traumatized patients. J Trauma. 1993;35:349–55. doi: 10.1097/00005373-199309000-00004.
    1. Blow O, Magliore L, Claridge JA, Butler K, Young JS. The golden hr and the silver day: detection and correction of occult hypoperfusion within 24 hrs improves outcome from major trauma. J Trauma. 1999;47:964–9. doi: 10.1097/00005373-199911000-00028.
    1. Claridge JA, Crabtree TD, Pelletier SJ, Butler K, Sawyer RG, Young JS. Persistent occult hypoperfusion is associated with a significant increase in infection rate and mortality in major trauma patients. J Trauma. 2000;48:8–14. doi: 10.1097/00005373-200001000-00003.
    1. Bakker J, Coffernils M, Leon M, Gris P, Vincent JL. Blood lactate levels are superior to oxygen-derived variables in predicting outcome in human septic shock. Chest. 1991;99:956–62. doi: 10.1378/chest.99.4.956.
    1. Friedman G, Berlot G, Kahn RJ, Vincent JL. Combined measurements of blood lactate concentrations and gastric intramucosal pH in patients with severe sepsis. Crit Care Med. 1995;23:1184–93. doi: 10.1097/00003246-199507000-00006.
    1. Bernardin G, Pradier C, Tiger F, Deloffre P, Mattei M. Blood pressure and arterial lactate level are early indicators of short-term survival in human septic shock. Intensive Care Med. 1996;22:17–25. doi: 10.1007/BF01728326.
    1. Marecaux G, Pinsky MR, Dupont E, Kahn RJ, Vincent JL. Blood lactate levels are better prognostic indicators than TNF and IL-6 levels in patients with septic shock. Intensive Care Med. 1996;22:404–8. doi: 10.1007/BF01712155.
    1. Bakker J, Gris P, Coffernils M, Kahn RJ, Vincent JL. Serial blood lactate levels can predict the development of multiple organ failure following septic shock. Am J Surg. 1996;171:221–6. doi: 10.1016/S0002-9610(97)89552-9.
    1. Kobayashi S, Gando S, Morimoto Y, Nanzaki S, Kemmotsu O. Serial measurement of arterial lactate concentrations as a prognostic indicator in relation to the incidence of disseminated intravascular coagulation in patients with systemic inflammatory response syndrome. Surg Today. 2001;31:853–9. doi: 10.1007/s005950170022.
    1. Nguyen HB, Rivers EP, Knoblich BP, Jacobsen G, Muzzin A, Ressler JA, et al. Early lactate clearance is associated with improved outcome in severe sepsis and septic shock. Crit Care Med. 2004;32:1637–42. doi: 10.1097/01.CCM.0000132904.35713.A7.
    1. Nguyen HB, Corbett SW, Steele R, Banta J, Clark RT, Hayes SR, et al. Implementation of a bundle of quality indicators for the early management of severe sepsis and septic shock is associated with decreased mortality. Crit Care Med. 2007;35:1105–12. doi: 10.1097/01.CCM.0000259463.33848.3D.
    1. Phua J, Koay ES, Lee KH. Lactate, procalcitonin, and amino-terminal pro-B-type natriuretic peptide versus cytokine measurements and clinical severity scores for prognostication in septic shock. Shock. 2008;29:328–33. doi: 10.1097/SHK.0b013e318150716b.
    1. Yang CS, Qiu HB, Huang YZ, Xie JF, Mo M, Liu SQ, et al. Prospective research on the prognosis of septic shock based on the change of lactate concentration in arterial blood. Zhonghua Wai Ke Za Zhi. 2009;47:685–8.
    1. Arnold RC, Shapiro NI, Jones AE, Schorr C, Pope J, Casner E, et al. Multicenter study of early lactate clearance as a determinant of survival in patients with presumed sepsis. Shock. 2009;32:35–9. doi: 10.1097/SHK.0b013e3181971d47.
    1. Nguyen HB, Loomba M, Yang JJ, Jacobsen G, Shah K, Otero RM, et al. Early lactate clearance is associated with biomarkers of inflammation, coagulation, apoptosis, organ dysfunction and mortality in severe sepsis and septic shock. J Inflamm (Lond) 2010;7:6. doi: 10.1186/1476-9255-7-6.
    1. Puskarich MA, Trzeciak S, Shapiro NI, Arnold RC, Heffner AC, Kline JA, et al. Prognostic value and agreement of achieving lactate clearance or central venous oxygen saturation goals during early sepsis resuscitation. Acad Emerg Med. 2012;19:252–8. doi: 10.1111/j.1553-2712.2012.01292.x.
    1. Zanaty OM, Megahed M, Demerdash H, Swelem R. Delta neutrophil index versus lactate clearance: early markers for outcome prediction in septic shock patients. Alex J Med. 2012;48:327–33. doi: 10.1016/j.ajme.2012.05.003.
    1. Puskarich MA, Trzeciak S, Shapiro NI, Albers AB, Heffner AC, Kline JA, et al. Whole blood lactate kinetics in patients undergoing quantitative resuscitation for severe sepsis and septic shock. Chest. 2013;143:1548–53. doi: 10.1378/chest.12-0878.
    1. Walker CA, Griffith DM, Gray AJ, Datta D, Hay AW. Early lactate clearance in septic patients with elevated lactate levels admitted from the emergency department to intensive care: time to aim higher? J Crit Care. 2013;28:832–7. doi: 10.1016/j.jcrc.2013.02.004.
    1. Liu V, Morehouse JW, Soule J, Whippy A, Escobar GJ. Fluid volume, lactate values, and mortality in sepsis patients with intermediate lactate values. Ann Am Thorac Soc. 2013;10:466–73. doi: 10.1513/AnnalsATS.201304-099OC.
    1. Marty P, Roquilly A, Vallee F, Luzi A, Ferre F, Fourcade O, et al. Lactate clearance for death prediction in severe sepsis or septic shock patients during the first 24 hrs in intensive care unit: an observational study. Ann Intensive Care. 2013;3:3. doi: 10.1186/2110-5820-3-3.
    1. Park JH, Lee J, Park YS, Lee CH, Lee SM, Yim JJ, et al. Prognostic value of central venous oxygen saturation and blood lactate levels measured simultaneously in the same patients with severe systemic inflammatory response syndrome and severe sepsis. Lung. 2014;192:435–40. doi: 10.1007/s00408-014-9564-y.
    1. Permpikul C, Sringam P, Tongyoo S. Therapeutic goal achievements during severe sepsis and septic shock resuscitation and their association with patients' outcomes. J Med Assoc Thai. 2014;97(Suppl 3):S176–83.
    1. Bao L, Zhang M, Yan P, Wu X, Shao J, Zheng R. Retrospective analysis of the value of arterial blood lactate level and its clearance rate on the prognosis of septic shock patients. Zhonghua Wei Zhong Bing Ji Jiu Yi Xue. 2015;27:38–42.
    1. Galbois A, Bige N, Pichereau C, Boelle PY, Baudel JL, Bourcier S, et al. Exploration of skin perfusion in cirrhotic patients with septic shock. J Hepatol. 2015;62:549–55. doi: 10.1016/j.jhep.2014.10.012.
    1. Lee SM, Kim SE, Kim EB, Jeong HJ, Son YK, An WS. Lactate clearance and vasopressor seem to be predictors for mortality in severe sepsis patients with lactic acidosis supplementing sodium bicarbonate: a retrospective analysis. PLoS One. 2015;10:e0145181. doi: 10.1371/journal.pone.0145181.
    1. Lokhandwala S, Moskowitz A, Lawniczak R, Giberson T, Cocchi MN, Donnino MW. Disease heterogeneity and risk stratification in sepsis-related occult hypoperfusion: a retrospective cohort study. J Crit Care. 2015;30:531–6. doi: 10.1016/j.jcrc.2015.01.009.
    1. Wang H, Li Z, Yin M, Chen XM, Ding SF, Li C, et al. Combination of Acute Physiology and Chronic Health Evaluation II score, early lactate area, and N-terminal prohormone of brain natriuretic peptide levels as a predictor of mortality in geriatric patients with septic shock. J Crit Care. 2015;30:304–9. doi: 10.1016/j.jcrc.2014.11.013.
    1. Bhat SR, Swenson KE, Francis MW, Wira CR. Lactate clearance predicts survival among patients in the emergency department with severe sepsis. West J Emerg Med. 2015;16:1118–26. doi: 10.5811/westjem.2015.10.27577.
    1. Chertoff J, Chisum M, Simmons L, King B, Walker M, Lascano J. Prognostic utility of plasma lactate measured between 24 and 48 h after initiation of early goal-directed therapy in the management of sepsis, severe sepsis, and septic shock. J Intensive Care. 2016;4:13. doi: 10.1186/s40560-016-0142-7.
    1. Drumheller BC, Agarwal A, Mikkelsen ME, Sante SC, Weber AL, Goyal M, et al. Risk factors for mortality despite early protocolized resuscitation for severe sepsis and septic shock in the emergency department. J Crit Care. 2016;31:13–20. doi: 10.1016/j.jcrc.2015.10.015.
    1. He HW, Liu DW, Long Y, Wang XT. High central venous-to-arterial CO2 difference/arterial-central venous O2 difference ratio is associated with poor lactate clearance in septic patients after resuscitation. J Crit Care. 2016;31:76–81. doi: 10.1016/j.jcrc.2015.10.017.
    1. Ha TS, Shin TG, Jo IJ, Hwang SY, Chung CR, Suh GY et al. Lactate clearance and mortality in septic patients with hepatic dysfunction. Am J Emerg Med. 2016;34:1011–15.
    1. Bolvardi E, Malmir J, Reihani H, Hashemian AM, Bahramian M, Khademhosseini P, et al. The role of lactate clearance as a predictor of organ dysfunction and mortality in patients with severe sepsis. Mater Sociomed. 2016;28:57–60. doi: 10.5455/msm.2016.28.57-60.
    1. Amir A, Saulters KJ, Olum S, Pitts K, Parsons A, Churchill C et al. Outcomes of patients with severe sepsis after the first 6 hrs of resuscitation at a regional referral hospital in Uganda. J Crit Care. 2016;33:78–83.
    1. Tian HH, Han SS, Lv CJ, Wang T, Li Z, Hao D, et al. The effect of early goal lactate clearance rate on the outcome of septic shock patients with severe pneumonia. Zhongguo Wei Zhong Bing Ji Jiu Yi Xue. 2012;24:42–5.
    1. Yu B, Tian HY, Hu ZJ, Zhao C, Liu LX, Zhang Y, et al. Comparison of the effect of fluid resuscitation as guided either by lactate clearance rate or by central venous oxygen saturation in patients with sepsis. Zhonghua Wei Zhong Bing Ji Jiu Yi Xue. 2013;25:578–83.
    1. Lyu X, Xu Q, Cai G, Yan J, Yan M. Efficacies of fluid resuscitation as guided by lactate clearance rate and central venous oxygen saturation in patients with septic shock. Zhonghua Yi Xue Za Zhi. 2015;95:496–500.
    1. Kuan WS, Ibrahim I, Leong BS, Jain S, Lu Q, Cheung YB, et al. Emergency department management of sepsis patients: a randomized, goal-oriented, noninvasive sepsis trial. Ann Emerg Med. 2016;67:367–78. doi: 10.1016/j.annemergmed.2015.09.010.
    1. Attana P, Lazzeri C, Chiostri M, Picariello C, Gensini GF, Valente S. Lactate clearance in cardiogenic shock following ST elevation myocardial infarction: a pilot study. Acute Card Care. 2012;14:20–6. doi: 10.3109/17482941.2011.655293.
    1. Attana P, Lazzeri C, Chiostri M, Picariello C, Gensini GF, Valente S. Strong-ion gap approach in patients with cardiogenic shock following ST-elevation myocardial infarction. Acute Card Care. 2013;15:58–62. doi: 10.3109/17482941.2013.776691.
    1. Park TK, Yang JH, Choi SH, Song YB, Hahn JY, Choi JH, et al. Clinical outcomes of patients with acute myocardial infarction complicated by severe refractory cardiogenic shock assisted with percutaneous cardiopulmonary support. Yonsei Med J. 2014;55:920–7. doi: 10.3349/ymj.2014.55.4.920.
    1. Guenther S, Theiss HD, Fischer M, Sattler S, Peterss S, Born F, et al. Percutaneous extracorporeal life support for patients in therapy refractory cardiogenic shock: initial results of an interdisciplinary team. Interact Cardiovasc Thorac Surg. 2014;18:283–91. doi: 10.1093/icvts/ivt505.
    1. Kliegel A, Losert H, Sterz F, Holzer M, Zeiner A, Havel C, et al. Serial lactate determinations for prediction of outcome after cardiac arrest. Medicine (Baltimore) 2004;83:274–9. doi: 10.1097/01.md.0000141098.46118.4c.
    1. Donnino MW, Miller J, Goyal N, Loomba M, Sankey SS, Dolcourt B, et al. Effective lactate clearance is associated with improved outcome in post-cardiac arrest patients. Resuscitation. 2007;75:229–34. doi: 10.1016/j.resuscitation.2007.03.021.
    1. Arnalich F, Menendez M, Lagos V, Ciria E, Quesada A, Codoceo R, et al. Prognostic value of cell-free plasma DNA in patients with cardiac arrest outside the hospital: an observational cohort study. Crit Care. 2010;14:R47. doi: 10.1186/cc8934.
    1. Le Guen M, Nicolas-Robin A, Carreira S, Raux M, Leprince P, Riou B, et al. Extracorporeal life support following out-of-hospital refractory cardiac arrest. Crit Care. 2011;15:R29. doi: 10.1186/cc9976.
    1. Starodub R, Abella BS, Grossestreuer AV, Shofer FS, Perman SM, Leary M, et al. Association of serum lactate and survival outcomes in patients undergoing therapeutic hypothermia after cardiac arrest. Resuscitation. 2013;84:1078–82. doi: 10.1016/j.resuscitation.2013.02.001.
    1. Donnino MW, Andersen LW, Giberson T, Gaieski DF, Abella BS, Peberdy MA, et al. Initial lactate and lactate change in post-cardiac arrest: a multicenter validation study. Crit Care Med. 2014;42:1804–11. doi: 10.1097/CCM.0000000000000332.
    1. Riveiro DF, de Oliveira VM, Braunner JS, Vieira SR. Evaluation of serum lactate, central venous saturation, and venous-arterial carbon dioxide difference in the prediction of mortality in postcardiac arrest syndrome. J Intensive Care Med. 2015. [Epub ahead of print]
    1. Williams TA, Martin R, Celenza A, Bremner A, Fatovich D, Krause J, et al. Use of serum lactate levels to predict survival for patients with out-of-hospital cardiac arrest: a cohort study. Emerg Med Australas. 2016;28:171–8. doi: 10.1111/1742-6723.12560.
    1. Zhao YF, Lin Y, Zhu XL. Clinical significance of early lactate clearance rate in patients with respiratory failure. Zhonghua Jie He He Hu Xi Za Zhi. 2010;33:183–7.
    1. Wu WH, Niu YY, Zhang CR, Xiao LB, Ye HS, Pan DM, et al. Combined APACH II score and arterial blood lactate clearance rate to predict the prognosis of ARDS patients. Asian Pac J Trop Med. 2012;5:656–60. doi: 10.1016/S1995-7645(12)60134-5.
    1. Zang Z, Xu H, Dong L, Gao F, Yan J. Prognostic significance of early lactate clearance rate for severe acute respiratory failure patients on extracorporeal membrane oxygenation. Zhonghua Jie He He Hu Xi Za Zhi. 2014;37:197–201.
    1. Liu XW, Ma T, Qu B, Ji Y, Liu Z. Prognostic value of initial arterial lactate level and lactate metabolic clearance rate in patients with acute paraquat poisoning. Am J Emerg Med. 2013;31:1230–5. doi: 10.1016/j.ajem.2013.04.019.
    1. Wu JF, Wu RY, Chen J, Ou-Yang B, Chen MY, Guan XD. Early lactate clearance as a reliable predictor of initial poor graft function after orthotopic liver transplantation. Hepatobiliary Pancreat Dis Int. 2011;10:587–92. doi: 10.1016/S1499-3872(11)60100-8.
    1. Scott S, Antonaglia V, Guiotto G, Paladino F, Schiraldi F. Two-hr lactate clearance predicts negative outcome in patients with cardiorespiratory insufficiency. Crit Care Res Pract. 2010;2010:917053.
    1. Mohamed KAE, Ahmed DAE. Prognostic value of lactate clearance in severe community-acquired pneumonia. Egypt J Chest Dis Tuberc. 2014;63:1053–8. doi: 10.1016/j.ejcdt.2014.05.011.
    1. Lee TR, Kang MJ, Cha WC, Shin TG, Sim MS, Jo IJ, et al. Better lactate clearance associated with good neurologic outcome in survivors who treated with therapeutic hypothermia after out-of-hospital cardiac arrest. Crit Care. 2013;17:R260. doi: 10.1186/cc13090.
    1. Matsumoto H, Nihei S, Endo T, Kanazawa A, Arai H, Nagata K, et al. Examination of relationship between lactate clearance and neurologic outcome in cardiac arrest induced by ventricular fibrillation. J UOEH. 2014;36:11–6. doi: 10.7888/juoeh.36.11.
    1. Qvisth V, Hagstrom-Toft E, Enoksson S, Bolinder J. Catecholamine regulation of local lactate production in vivo in skeletal muscle and adipose tissue: role of -adrenoreceptor subtypes. J Clin Endocrinol Metab. 2008;93:240–6. doi: 10.1210/jc.2007-1313.
    1. Contenti J, Occelli C, Corraze H, Lemoel F, Levraut J. Long-term beta-blocker therapy decreases blood lactate concentration in severely septic patients. Crit Care Med. 2015;43:2616–22. doi: 10.1097/CCM.0000000000001308.
    1. Orbegozo Cortes D, Rayo Bonor A, Vincent JL. Isotonic crystalloid solutions: a structured review of the literature. Br J Anaesth. 2014;112:968–81. doi: 10.1093/bja/aeu047.
    1. Didwania A, Miller J, Kassel D, Jackson EV, Jr, Chernow B. Effect of intravenous lactated Ringer's solution infusion on the circulating lactate concentration: Part 3. Results of a prospective, randomized, double-blind, placebo-controlled trial. Crit Care Med. 1997;25:1851–4. doi: 10.1097/00003246-199711000-00024.
    1. Dezman ZD, Comer AC, Narayan M, Scalea TM, Hirshon JM, Smith GS. Alcohol consumption decreases lactate clearance in acutely injured patients. Injury. 2016. [Epub ahead of print]
    1. Kruse JA, Zaidi SA, Carlson RW. Significance of blood lactate levels in critically ill patients with liver disease. Am J Med. 1987;83:77–82. doi: 10.1016/0002-9343(87)90500-6.
    1. Chiolero R, Tappy L, Gillet M, Revelly JP, Roth H, Cayeux C, et al. Effect of major hepatectomy on glucose and lactate metabolism. Ann Surg. 1999;229:505–13. doi: 10.1097/00000658-199904000-00009.
    1. Tapia P, Soto D, Bruhn A, Alegria L, Jarufe N, Luengo C, et al. Impairment of exogenous lactate clearance in experimental hyperdynamic septic shock is not related to total liver hypoperfusion. Crit Care. 2015;19:188. doi: 10.1186/s13054-015-0928-3.
    1. Schmidt LE, Larsen FS. Prognostic implications of hyperlactatemia, multiple organ failure, and systemic inflammatory response syndrome in patients with acetaminophen-induced acute liver failure. Crit Care Med. 2006;34:337–43. doi: 10.1097/01.CCM.0000194724.70031.B6.
    1. Hernandez G, Luengo C, Bruhn A, Kattan E, Friedman G, Ospina-Tascon GA, et al. When to stop septic shock resuscitation: clues from a dynamic perfusion monitoring. Ann Intensive Care. 2014;4:30. doi: 10.1186/s13613-014-0030-z.

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