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2012, Number 4

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Med Crit 2012; 26 (4)

Lactate clearance as a prognostic marker in patients with severe sepsis and septic shock in the intensive care UNIT

Saldaña VR, Hernández PJ, Ramírez RA, González AJ, Meza CME

Language: Spanish
References: 30
Page: 194-200
PDF size: 148.39 Kb.


ABSTRACT

Objective: This study try to evaluate the association between mortality at 28 days, scores of multiple organ failure, hemodynamic variables and lactate clearance at 6 hours in patients with severe sepsis and septic shock.
Materials and methods: This is a cohort study of 34 patients with severe sepsis and septic shock in Intensive Care Unit at Christus Muguerza Hospital We obtain data of lactate, APACHE II score, SOFA score, vital signs, accumulated fluids, requirements of vasoactive medications and steroids, lactate clearance at 6, 24 and 48 h.
Results: The mean lactate clearance to 6 hours was -1.18 ± 72.78%. The 28 day global mortality was 44.10%. For the cohort of lactate clearance at 6 h, and ‹ 10% of lactate clearance estimated a Relative Risk of 2.21 with 95% CI [1.02-4.74]. The mortality in the ≥ 10% clearance was 26.3% against 66.7% in the clearance ‹ 10% (p = 0.01). We found that lactate clearance at 6 h of 13.42% has the best sensitivity value (69.23%) and specificity (68.42%).
Conclusions: The clearance of lactate in 6 hours is a predictor of mortality at 28 days in patients with severe sepsis and septic shock in the ICU.


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