Lactate Clearance in Septic Shock Is Not a Surrogate for Improved Microcirculatory Flow
نویسندگان
چکیده
منابع مشابه
Is lactate clearance impaired in septic shock?
In a recent article in Critical Care, Tapia and colleagues evaluated the relationship between exogenous lactate clearance and liver perfusion in a short-term model of endotoxemic shock [1]. The authors concluded that the very low portal-hepatic vein lactate gradient was indicative of the inability of the liver to metabolize the increased lactate load. Although we believe that the authors addres...
متن کاملEarly lactate clearance is associated with improved outcome in severe sepsis and septic shock.
OBJECTIVE Serial lactate concentrations can be used to examine disease severity in the intensive care unit. This study examines the clinical utility of the lactate clearance before intensive care unit admission (during the most proximal period of disease presentation) as an indicator of outcome in severe sepsis and septic shock. We hypothesize that a high lactate clearance in 6 hrs is associate...
متن کاملImpairment of exogenous lactate clearance in experimental hyperdynamic septic shock is not related to total liver hypoperfusion
INTRODUCTION Although the prognostic value of persistent hyperlactatemia in septic shock is unequivocal, its physiological determinants are controversial. Particularly, the role of impaired hepatic clearance has been underestimated and is only considered relevant in patients with liver ischemia or cirrhosis. Our objectives were to establish whether endotoxemia impairs whole body net lactate cle...
متن کاملRelationship of systemic, hepatosplanchnic, and microcirculatory perfusion parameters with 6-hour lactate clearance in hyperdynamic septic shock patients: an acute, clinical-physiological, pilot study
BACKGROUND Recent clinical studies have confirmed the strong prognostic value of persistent hyperlactatemia and delayed lactate clearance in septic shock. Several potential hypoxic and nonhypoxic mechanisms have been associated with persistent hyperlactatemia, but the relative contribution of these factors has not been specifically addressed in comprehensive clinical physiological studies. Our ...
متن کاملPathophysiology of microcirculatory dysfunction and the pathogenesis of septic shock
Multiple experimental and human trials have shown that microcirculatory alterations are frequent in sepsis. In this review, we discuss the various mechanisms that are potentially involved in their development and the implications of these alterations. Endothelial dysfunction, impaired inter-cell communication, altered glycocalyx, adhesion and rolling of white blood cells and platelets, and alte...
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ژورنال
عنوان ژورنال: Academic Emergency Medicine
سال: 2016
ISSN: 1069-6563
DOI: 10.1111/acem.12928