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Metabolites 2018, 8(2), 28; https://doi.org/10.3390/metabo8020028

Adipose Tissue Lactate Clearance but Not Blood Lactate Clearance Is Associated with Clinical Outcome in Sepsis or Septic Shock during the Post-Resuscitation Period

1
Endocrine Unit, Elena Venizelou Hospital, Athens 11521, Greece
2
Second Department of Critical Care Medicine, Attikon University Hospital, National and Kapodistrian University of Athens, Medical School, Athens 10462, Greece
3
Department of Endocrinology, Evangelismos Hospital, Athens 10676, Greece
4
First Department of Critical Care Medicine, Evangelismos Hospital, National and Kapodistrian University of Athens, Medical School, Athens 10676, Greece
*
Author to whom correspondence should be addressed.
Received: 13 March 2018 / Revised: 16 April 2018 / Accepted: 20 April 2018 / Published: 21 April 2018
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Abstract

No study has directly measured tissue lactate clearance in patients with sepsis during the post-resuscitation period. In this study we aimed to assess in ICU patients with sepsis (n = 32) or septic shock (n = 79)—during the post-resuscitation phase—the relative kinetics of blood/tissue lactate clearances and to examine whether these are associated with outcome. We measured serially—over a 48-h period—blood and adipose tissue interstitial fluid lactate levels (with microdialysis) and we calculated lactate clearance. Statistics included mixed model analysis, Friedman’s analysis of variance, Wilcoxon’s test, Mann-Whitney’s test, receiver operating characteristics curves and logistic regression. Forty patients died (28-day mortality rate = 28%). Tissue lactate clearance was higher compared to blood lactate clearance at 0–8, 0–12, 0–16, 0–20 and 0–24 h (all p < 0.05). Tissue lactate clearance was higher in survivors compared to non-survivors at 0–12, 0–20 and 0–24 h (all p = 0.02). APACHE II along with tissue lactate clearance <30% at 0–12, 0–20 and 0–24 h were independent outcome predictors. We did not find blood lactate clearance to be related to survival. Thus, in critically ill septic patients, elevated tissue (but not blood) lactate clearance, was associated with a favorable clinical outcome. View Full-Text
Keywords: microdialysis; intensive care unit; sepsis; lactate clearance; tissue hypoxia; outcome microdialysis; intensive care unit; sepsis; lactate clearance; tissue hypoxia; outcome
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This is an open access article distributed under the Creative Commons Attribution License which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. (CC BY 4.0).
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Ilias, I.; Apollonatou, S.; Vassiliadi, D.-A.; Nikitas, N.; Theodorakopoulou, M.; Diamantakis, A.; Kotanidou, A.; Dimopoulou, I. Adipose Tissue Lactate Clearance but Not Blood Lactate Clearance Is Associated with Clinical Outcome in Sepsis or Septic Shock during the Post-Resuscitation Period. Metabolites 2018, 8, 28.

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