Hyperlactatemia and the Importance of Repeated Lactate Measurements in Critically Ill Patients

Aclaramiento de lactato sepsis

Hyperlactatemia is defined as increased levels of lactate in blood, more specifically lactate levels greater than 2 mmol/L, and is prevalent in patients with a critical illness. This study, carried out by Godinjak et al., aims to to describe the prevalence of hyperlactatemia and stress that repeated lactate measurements over time could be more useful for clinicians as opposed to a single lactate measurement for risk stratification in critically ill patients, as well as the associated mortality.

This study was conducted in the ICU of University of Sarajevo between July and December of 2015. In that period of time, 94 patients were admitted, of which 70 patients met the inclusion criteria and thus were included in the study.

Different data was collected from the patients, including lactate concentrations upon admission, after 24 and 48 hours, and at the clinical outcomes. Based on the clinical outcomes, patients were divided into two groups: the survivors group (patients who were discharged from the hospital), and the non-survivors group (patients who died in hospital).

Hyperlactatemia (lactate levels higher than 2 mmol/L) upon admission was present in 64 (91.4%) of the admitted patients, with mean lactate concentration 4.13 ± 1.21 mmol/L. In this study, there was statistically a significant difference between survivors versus non-survivors in the mean lactate concentration at admission, after 24 hours and 48 hours. Lactate levels at 48 hours were the independent predictor for mortality, with a cut-off value of 2.25 mmol/L, and sensitivity of 72.2 % and specificity of 92.1%.

The authors concluded that blood lactate concentrations higher than 2.25 mmol/L should be used by doctors to identify patients at higher risk of death.

This study was completed by Amina Godinjak, Selma Jusufovic, Admir Rama, Amer Iglica, Faris Zvizdic, Adis Kukuljac, Ira Tancica and Sejla Rozajac, and it was published in December 2017 by Journal of the Academy of Medical Sciences in Bosnia and Herzegovina (MED ARCH. 2017 DEC; 71(6): 404-407)

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Hyperlactatemia and the Importance of Repeated Lactate Measurements in Critically Ill Patients