Skip to main content
Log in

Plasma lactate as prognostic marker of septic shock with acute respiratory distress syndrome

  • Original Article
  • Published:
Indian Journal of Clinical Biochemistry Aims and scope Submit manuscript

Abstract

The present study was conducted to study the significance of lactate as a prognostic marker in patients of septic shock with acute respiratory distress syndrome. This study was conducted on 50 critically ill patients of septic shock with acute respiratory distress syndrome between the age group of 20–60 years and 50 controls. Plasma lactate and serum electrolytes were determined among controls and patients. Arterial blood gas analysis for pO2, pCO2 and pH was carried out among patients. Arterial base excess and anion gap were calculated and lactate was correlated with base excess, anion gap and pCO2 at 5% level of significance. Higher lactate, negative arterial base excess, high anion gap, low pO2 and high pCO2 were observed among patients. Lactate was positively correlated pCO2 and anion gap and negatively with pO2 and base excess among patients. Hyperlactatemia increasing with progression of septic shock with acute respiratory distress syndrome may suggest that lactate may be used as noninvasive prognostic marker or guide to resuscitation.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Similar content being viewed by others

References

  1. Bernard GR, Artigas A, Brigham KL, Carlet J, Falke K, Hudson L, Lamy M, Legall JR, Morris A, Spragg R. The American-European Consensus Conference on ARDS. Definitions, mechanisms, relevant outcomes and clinical trial coordination. Am J Respir Crit Care Med 1994; 149(3): 818–824.

    CAS  PubMed  Google Scholar 

  2. Leverve XM, Mustafa I. Lactate. A key metabolite in the intercellular metabolic interplay. Crit Care 2002; 6(4): 284–285.

    Article  PubMed  Google Scholar 

  3. David B Sacks. Carbohydrates. In: Burtis AC, Ashwood RE, editors. Tietz text book of clinical chemistry 4th edn: Philadelphia: Saunders; 2006: 837–901.

    Google Scholar 

  4. Mitchell GS, James SK. Electrolytes and blood gases. In; Burtis AC, Ashwood RE, editors. Tietz textbook of clinical chemistry 4th edn:Philadelphia: Saunders;2006: 983–1018.

    Google Scholar 

  5. Caples SM, Hubmayr RD. Respiratory monitoring tools in the intensive care unit. Curr Opinion in Crit Care 2003; 9(3): 230–235.

    Article  Google Scholar 

  6. Siggaard-Andersen O, Wimberly PD, Fogh-Andersen N, Gothgen IH. Measured and derived quantities with modern pH and blood gas equipment: calculation algorithms with 54 equations. Scand J Clin Lab Invest 1988; 48(189): 7–15.

    Article  Google Scholar 

  7. Figge J, Jabor A, Kazda A, Fencl V. Anion gap and hypoproteinemia. Crit Care Med 1998; 26(11): 1807–1810.

    CAS  PubMed  Google Scholar 

  8. Gutierrez G, Wulf-Gutierrez ME, Reines HD. Monitoring oxygen transport and tissue oxygenation. Curr Opinion in Anaesthesiol 2004; 17(2): 107–117.

    Article  Google Scholar 

  9. Routsi CS, Zakynthinos H, Bardouniotou D, Alepopoulou E, Zakynthinos D, Kazi B, Ioanidou, Roussos C. Arteriovenous differences in lactate and lactate pyruvate ratio correlate with hypoxemic lung disease. AmJ Respir Crit Care Med 1996;153(5): 385.

    Google Scholar 

  10. Backer D, Creteur J, Zhang H, Norrenberg M, Vincent JL. Lactate Production by the Lungs in Acute Lung Injury. Am J Respir Crit Care Med 1997; 156(4): 1099–1104.

    PubMed  Google Scholar 

  11. Kilpatrick-Smith L, Erecinska M. Cellular effects of endotoxin in vitro: I. Effect of endotoxin on mitochondrial substrate metabolism and intracellular calcium. Circ Shock 1983; 11(2): 85–99.

    CAS  PubMed  Google Scholar 

  12. Rhodes A, Cusack RJ. Arterial blood gas analysis and lactate. Curr Opinion in Crit Care 2000; 6(3): 227–231.

    Article  Google Scholar 

  13. Rocktaeschel J, Morimatsu H, Uchino S, Bellomo R. Unmeasured anions in critically ill patients: can they predict mortality? Crit Care Med 2003; 31(8): 2131–2136.

    Article  CAS  PubMed  Google Scholar 

  14. Smith I, Kumar P, Molloy S, Rhodes A, Newman PJ, Grounds RM, Bennett ED. Base excess and lactate as prognostic indicators for patients admitted to intensive care. Inten Care Med 2001; 27(1): 74–83.

    Article  CAS  Google Scholar 

  15. Eachempati SR, Reed RL, Barie PS. Serum bicarbonate concentration correlates with arterial base deficit in critically ill patients. Surg Infect (Larchmt) 2003; 4(2): 193–197.

    Article  Google Scholar 

  16. Crawford A. An audit of the patient’s experience of arterial blood gas testing. Br J Nurs 2004; 13(9): 529–532.

    PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to D. R. Suresh.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Nanda, S.K., Suresh, D.R. Plasma lactate as prognostic marker of septic shock with acute respiratory distress syndrome. Indian J Clin Biochem 24, 433–435 (2009). https://doi.org/10.1007/s12291-009-0078-y

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s12291-009-0078-y

Key Words

Navigation