Intensive Care Medicine

, Volume 41, Issue 10, pp 1862–1863 | Cite as

Early lactate clearance-guided therapy in patients with sepsis: a meta-analysis with trial sequential analysis of randomized controlled trials

  • Wan-Jie Gu
  • Zhongheng Zhang
  • Jan BakkerEmail author

Dear Editor,

Sepsis represents a global problem with high economic burden for health care systems. Since 2002, the Surviving Sepsis Campaign has recommended early quantitative resuscitation for patients with severe sepsis and septic shock with a recent update [1]. However, the optimal goals for quantitative resuscitation remain uncertain. Lactate clearance, defined by the change of lactate levels between two points in time, as a more rapid and less costly parameter, has the potential to be such a promising goal for quantitative resuscitation. We performed a meta-analysis of randomized controlled trials (RCTs) to evaluate the effect of early lactate clearance-guided therapy on mortality and other outcomes in patients with sepsis.

We searched PubMed, Embase, and Cochrane Central Register of Controlled Trials to identify RCTs that evaluated the effect of early lactate clearance-guided therapy on clinical outcomes in adults with sepsis. The search terms used were “lactate clearance”, and...


Electronic Supplementary Material Severe Sepsis Intensive Care Unit Stay Survive Sepsis Campaign Lactate Clearance 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.


Compliance with Ethical Standards

Conflicts of interest

The authors declare to have no possible conflict of interest.

Supplementary material

134_2015_3955_MOESM1_ESM.doc (316 kb)
Supplementary material 1 (DOC 316 kb)


  1. 1.
    Dellinger RP, Levy MM, Rhodes A et al (2013) Surviving Sepsis Campaign: international guidelines for management of severe sepsis and septic shock, 2012. Intensive Care Med 39:165–228CrossRefPubMedGoogle Scholar
  2. 2.
    Jansen TC, van Bommel J, Schoonderbeek FJ et al (2010) Early lactate-guided therapy in intensive care unit patients: a multicenter, open-label, randomized controlled trial. Am J Respir Crit Care Med 182:752–761CrossRefPubMedGoogle Scholar
  3. 3.
    Jones AE, Shapiro NI, Trzeciak S et al (2010) Lactate clearance vs central venous oxygen saturation as goals of early sepsis therapy: a randomized clinical trial. JAMA 303:739–746PubMedCentralCrossRefPubMedGoogle Scholar
  4. 4.
    Tian HH, Han SS, Lv CJ et al (2012) The effect of early goal lactate clearance rate on the outcome of septic shock patients with severe pneumonia. Zhongguo Wei Zhong Bing Ji Jiu Yi Xue 24:42–45PubMedGoogle Scholar
  5. 5.
    Yu B, Tian HY, Hu ZJ et al (2013) Comparison of the effect of fluid resuscitation as guided either by lactate clearance rate or by central venous oxygen saturation in patients with sepsis. Zhonghua Wei Zhong Bing Ji Jiu Yi Xue 25:578–583PubMedGoogle Scholar

Copyright information

© Springer-Verlag Berlin Heidelberg and ESICM 2015

Authors and Affiliations

  1. 1.Department of AnesthesiologyAffiliated Drum Tower Hospital of Medical College of Nanjing UniversityNanjingChina
  2. 2.Department of Critical Care MedicineJinhua Municipal Central Hospital, Jinhua Hospital of Zhejiang UniversityJinhuaChina
  3. 3.Department of Intensive Care AdultsErasmus MC University Medical CentreRotterdamThe Netherlands
  4. 4.Department of Intensive CarePontificia Universidad Católica de ChileSantiagoChile
  5. 5.Division of Pulmonary and Critical CareColumbia University College for Physicians and Surgeons/New York Presbyterian HospitalNew YorkUSA

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