Prognostic Value of Serum Lactate Levels in Critically Ill Patients in an Intensive Care Unit
, , , , and | Jan 31, 2020
About this article
Article Category: Research Article
Published Online: Jan 31, 2020
Page range: 59 - 64
Received: Nov 18, 2019
Accepted: Jan 29, 2020
DOI: https://doi.org/10.2478/jccm-2020-0005
Keywords
© 2020 Hedgar Berty Gutiérrez, Yenisey Arteaga Concepción, Jorge Soneira Pérez, Yanín Díaz Lara, Félix Mario Rivero López, Pedro Rosales Contreras, published by Sciendo
This work is licensed under the Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 License.
Fig. 1
Results of the Cox regression analysis.
| Variable | AHR | 95% IC | P |
|---|---|---|---|
| Serum lactate | 1,28 | 1,07-1,53 | 0,008 |
| APACHE II | 1,07 | 1,00-1,14 | 0,06 |
| SOFA | 0,96 | 0,89-1,03 | 0,258 |
| Excess Base | 1,02 | 0,97-1,07 | 0,417 |
Analytical values and physiological variables in the first six hours after admission to the ICU.
| Variable | Serum lactate >2 mmol/l (N= 80) | Serum lactate ≤ 2 mmol/l (N= 65) | P |
|---|---|---|---|
| Leukocytes / mm3, median (IQR **) | 12,5 (8,7-18,9) | 11,6 (8,5-14,3) | 0,055 |
| Hematocrit (%), median (IQR **) | 31,2 (5,8) | 32 (8,3) | 0,482 |
| Platelet count / mm3, median (IQR **) | 200 (164,3-279,0) | 200 (170,0-239,0) | 0,510 |
| Blood Glucose (mmol/l), median (IQR **) | 7,2 (5,9-8,9) | 6,8 (58,7-9,6) | 0,066 |
| Aminotransferase Aspartate (u/l), median (IQR **) | 42,5 (29,3-75,6) | 41,0 (31,5-69,5) | 0,469 |
| Aminotransferase Alanine (u/l), median (IQR **) | 40,0 (28,3-60,0) | 40,0 (29,0-58,0) | 0,124 |
| Albumin (g/l), median (IQR **) | 33,0 (27,3-37,0) | 35,0 (28,0-38,0) | 0,164 |
| Creatinine (Mmol / l), median (IQR **) | 90,5 (66,3-129,5) | 86 (68,5-114,0) | 0,044 |
| PH, median (IQR **) | 7,41 (7,35-7,45) | 7,42 (7,37-7,45) | 0,225 |
| PCO2 (mmHg), median (IQR **) | 35,3 (21,1-42,8) | 35,0 (30,1-42,6) | 0,08 |
| PO2 (mmHg), median (IQR **) | 86,5 (70,0-115,3) | 90,0(72,9-115,0) | 0,175 |
| Base Excess, median (IQR **) | -0,7 (-4,1-2,6) | -0,1 (-3,6-2,2) | 0,341 |
| Bicarbonate, median (IQR **) | 23,4 (20,9-26,0) | 24,0 (19,9-26,3) | 0,407 |
| PO2 / FiO2, average (SD *) | 306,9 (137,8) | 341,5 (117,9) | 0,232 |
| D(A-a)O2, median (IQR **) | 81,0 (29,2-140,6) | 56,6 (17,5-97,7) | 0,241 |
| Sodium (mmol / l), median (IQR **) | 136,0 (132,0-141,0) | 133,0 (130,0-138,5) | 0,056 |
| Potassium (mmol / l), median (IQR **) | 3,8 (3,4-4,2) | 3,7 (3,4-4,2) | 0,845 |
| Heart Rate (bpm), average (SD *) | 93,9 (21,0) | 97,3 (18,5) | 0,374 |
| Respiratory rate (rpm), median (IQR **) | 22,0 (19,0-25,8) | 21,0 (20,0-25,0) | 0,252 |
| Medium Arterial Tension (mmHg), median (IQR **) | 92,3 (82,1-99,8) | 93 (80,5-102,2) | 0,021 |
General characteristics of the population, stratified according to serum lactate values in the first six hours after admission to the ICU.
| Variable | Serum lactate >2mmol/ (N=80) | Serum lactate ≤ 2mmol/l (N=65) | P |
|---|---|---|---|
| Age, average (SD) | 53,9 (16,8) | 45,1 (17,6) | 0,203 |
| Sex, n (%) | |||
| Male | 46 (57,5) | 26 (40,0) | 0,860 |
| Female | 34 (42,5) | 39 (60,0) | |
| Apache II, median (IQR **) | 14 (11,0-20,0) | 8 (5,0-13,0) | 0,002 |
| SOFA, median (IQR **) | 10,5 (6,0-15,0) | 5 (1,5-8,0) | 0,098 |
| Cause of admission to the ICU, n (%) | |||
| Cardiovascular | 8 (10,0) | 1 (1,5) | 0,520 |
| Pulmonary | 6 (7,5) | 7 (10,8) | 0,463 |
| Neurological | 6 (7,5) | 5 (7,7) | 0,691 |
| Traumatic | 26 (32,5) | 19 (29,2) | 0,05 |
| Infectious | 16 (20,0) | 11 (16,9) | 0,041 |
| Gastrointestinal | 8 (10,0) | 8 (12,3) | 0,738 |
| Poisoning | 1 (1,3) | 4 (6,2) | 0,583 |
| Other | 9 (11,3) | 10 (15,4) | 0,124 |
| Hemodynamic support, n (%) | 14 (17,5) | 4 (6,2) | 0,008 |
| Use Mechanical Ventilation, n (%) | 25 (31,3) | 21(32,3) | <0,0001 |
| Stay in ICU, median (IQR **) | 5,0 (4,0-7,0) | 6,0 (4,0-7,5) | 0,756 |