Lactate concentrations in the rectal lumen in patients in early septic shock

TY - JOUR

T1 - Lactate concentrations in the rectal lumen in patients in early septic shock

AU - Ibsen, M.

AU - Tenhunen, J.

AU - Wiis, J.

AU - Waldau, T

AU - Lauritsen, A.O.

AU - Thornberg, K.

AU - Joensen, H.

AU - Perner, A.

AU - Ibsen, Michael

AU - Joensen, H

PY - 2010/8

Y1 - 2010/8

N2 - Background: Previously, we observed that rectal luminal lactate was higher in non-survivors compared with survivors of severe sepsis or septic shock persisting >24 h. The present study was initiated to further investigate this tentative association between rectal luminal lactate and mortality in a larger population of patients in early septic shock. Methods: A prospective observational multicentre study of 130 patients with septic shock at six general ICU's of university hospitals. Six to 24 h after the onset of septic shock, the concentration of lactate in the rectal lumen was estimated by a 4-h equilibrium dialysis. Dialysate concentrations of lactate were determined using an auto-analyser. Results: The overall 30-day mortality was 32%, with age and Simplified acute physiology scores II and sequential organ failure assessment scores being significantly higher in non-survivors. In contrast, there were no differences in concentrations of lactate in the rectal lumen [2.2 (1.4-4.1) and 2.8 (1.6-5.1) mmol/l (P=0.34)] (medians and 25th-75th percentiles) or arterial blood [2.1 (1.4-4.2) and 2.0 (1.3-3.2) mmol/l (P=0.15)] between non-survivors and survivors. The rectal-arterial difference of the lactate concentration was higher in survivors. There were no differences in blood pressure, noradrenaline dose or central venous oxygen saturation between the groups. Conclusion: In this prospective, observational study of unselected patients with early septic shock, there was no difference in the concentration of lactate in the rectal lumen between non-survivors and survivors. Trial Registration: Clinicaltrials.gov (no: NCT00197938).

AB - Background: Previously, we observed that rectal luminal lactate was higher in non-survivors compared with survivors of severe sepsis or septic shock persisting >24 h. The present study was initiated to further investigate this tentative association between rectal luminal lactate and mortality in a larger population of patients in early septic shock. Methods: A prospective observational multicentre study of 130 patients with septic shock at six general ICU's of university hospitals. Six to 24 h after the onset of septic shock, the concentration of lactate in the rectal lumen was estimated by a 4-h equilibrium dialysis. Dialysate concentrations of lactate were determined using an auto-analyser. Results: The overall 30-day mortality was 32%, with age and Simplified acute physiology scores II and sequential organ failure assessment scores being significantly higher in non-survivors. In contrast, there were no differences in concentrations of lactate in the rectal lumen [2.2 (1.4-4.1) and 2.8 (1.6-5.1) mmol/l (P=0.34)] (medians and 25th-75th percentiles) or arterial blood [2.1 (1.4-4.2) and 2.0 (1.3-3.2) mmol/l (P=0.15)] between non-survivors and survivors. The rectal-arterial difference of the lactate concentration was higher in survivors. There were no differences in blood pressure, noradrenaline dose or central venous oxygen saturation between the groups. Conclusion: In this prospective, observational study of unselected patients with early septic shock, there was no difference in the concentration of lactate in the rectal lumen between non-survivors and survivors. Trial Registration: Clinicaltrials.gov (no: NCT00197938).

U2 - http://dx.doi.org/DOI 10.1111/j.1399-6576.2010.02263.x

DO - http://dx.doi.org/DOI 10.1111/j.1399-6576.2010.02263.x

M3 - Journal article

SN - 0001-5172

VL - 54

SP - 827

EP - 832

JO - Acta Anaesthesiologica Scandinavica

JF - Acta Anaesthesiologica Scandinavica

IS - 7

ER -