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Related Experiment Videos

Serial lactate determinations during circulatory shock.

J L Vincent, P Dufaye, J Berré

    Critical Care Medicine
    |June 1, 1983
    PubMed
    Summary
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    Monitoring blood lactate levels during fluid resuscitation helps predict patient outcomes in shock. A consistent decrease in lactate indicates a positive response to treatment, while stable levels suggest a poor prognosis.

    Area of Science:

    • Critical Care Medicine
    • Biochemistry
    • Emergency Medicine

    Background:

    • Lactate accumulation is a marker of anaerobic metabolism and tissue hypoperfusion.
    • Assessing lactacidemia (lactic acidosis) is crucial in managing critically ill patients.
    • Prognostic indicators in shock are vital for guiding therapeutic interventions.

    Purpose of the Study:

    • To investigate the prognostic value of the time course of lactacidemia during fluid resuscitation.
    • To evaluate lactate concentration changes as an early indicator of treatment response in noncardiogenic shock.

    Main Methods:

    • Prospective study of 27 patients with noncardiogenic shock, seizures, or cardiac arrest.
    • Serial lactate measurements were taken during fluid resuscitation.

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  • Lactate levels were correlated with patient outcomes (survival or expiration).

    • Main Results:

    • Patients who survived shock showed a consistent decrease in lactate levels within 60 minutes of fluid resuscitation.
    • Patients who expired despite treatment had no significant change in lactacidemia.
    • Repeated lactate measurements were more predictive of outcome than initial values.

    Conclusions:

    • The dynamic changes in lactate concentration during resuscitation are a reliable prognostic index in circulatory shock.
    • Monitoring lactacidemia provides an objective and early evaluation of therapeutic effectiveness.
    • Serial lactate monitoring can guide clinical decision-making in critical care settings.