Serial Lactate Measurements and Their Predictive Validity of Early Mortality in Patients with Multiple Trauma Admitted to the Intensive Care Unit

Multiple trauma is the third leading cause of death worldwide. Usually, patients with polytrauma present with hypovolemic shock that determines different degrees of tissue hypoperfusion. The authors emphasize that it is necessary to have a biomarker that allows to quickly and reliably evaluate the diagnostic process of hypoperfusion during its early phase, in order to take the necessary measures to reduce the mortality rate. Lactate is an important tool for assessing the magnitude of hypoperfusion.

It has been established that lactate clearance in the first 6 hours is a prognostic measure of mortality in patients with multiple trauma. The aim of this study was to evaluate the capacity of serial lactate measurements and their clearance (on admission and at 12 and 24 hours) to predict the mortality of patients with polytrauma admitted to the Intensive Care Unit.

The authors performed a longitudinal cohort observational study in patients admitted with multiple trauma in the ICU of a Colombian University Clinic. Lactic acid was serially measured at hospital admission and at 12 and 24 hours after admission, and lactate clearance at 12 and 24 hours was determined to establish the association of these measurements and mortality at 7 days post admission.

The results of this study, carried out on 233 patients with a mean age of 38 years, show that lactate levels higher than 2.35 mEq / L at 24 hours of hospital admission are associated with an increased risk of mortality. The study also showed that the negative lactate clearance determined a higher mortality rate, especially 24 hours after admission.

This study was carried out by Henry Oliveros-Rodríguez, Rodrigo Estupiñán-López and Juliana Rodríguez-Gómez and published in 2017 by Revista Colombiana de Anestesiología (Colombian Journal of Anesthesiology) under the original title “Mediciones seriadas del lactato y su validez predictiva de la mortalidad temprana en los pacientes con politrauma que ingresan a la unidad de cuidado intensivo”

Please click here to access the original article, written in Spanish:
Mediciones Seriadas de Lactato y su Validez Predictiva de la Mortalidad Temprana en los Pacientes
con Politrauma que Ingresan a la Unidad de Cuidado Intensivo