Blood Lactate And Lactate Clearance: Refined Biomarker And Prognostic Marker In Burn Resuscitation

Area of Science:

• Critical Care Medicine
• Burn Surgery
• Trauma Management

Background:

• Effective resuscitation is vital for burn patients to maintain end-organ perfusion.
• Current markers for optimal burn resuscitation endpoints remain undefined.
• Lactate and lactate clearance are potential indicators of resuscitation effectiveness.

Purpose of the Study:

• To assess the role of blood lactate and lactate clearance in burn resuscitation.
• To investigate the association between lactate levels/clearance and mortality/sepsis in burn patients.

Main Methods:

• Retrospective study of 203 burn patients (18-50 years) with 30-60% total body surface area burns.
• Patients stratified by admission blood lactate (<2 mmol/L vs. >2 mmol/L) and 24-hour clearance.
• Analysis of mortality and sepsis rates across subgroups.

Main Results:

• Subgroup with persistent high lactate (>2 mmol/L at 24 hours) showed significantly higher mortality (57.9%) and sepsis (43.5%) rates.
• Patients achieving lactate clearance (<2 mmol/L within 24 hours) had outcomes comparable to those with initially low lactate.
• Persistent lactic acidosis at 24 hours was an independent predictor of increased mortality and sepsis.

Conclusions:

• Blood lactate levels and clearance within 24 hours correlate with mortality and sepsis in burn injuries.
• Persistent lactic acidosis is a significant risk factor for adverse outcomes in burn patients.
• Lactate dynamics may serve as a valuable marker for guiding burn resuscitation.