PURPOSE: To correlate point of entry lactate level in septic patients with need for pressor(s), dosage of pressor(s), need for/duration of mechanical ventilation, blood culture results, mortality in MICU and length of MICU stay.
METHODS: Retrospective review of 138 consecutively sampled septic patients admitted at Queens Hospital Center MICU in 2008-2009. It excluded patients with predefined non-sepsis related causes of lactate elevation. Extracted data included age, gender, point of entry lactate level, pressor(s) use and peak amount of pressor per unit weight within 24 hoursof admission, need for/duration of mechanical ventilation, blood culture results and MICU outcome. Data was analyzed using STAT TOOLS add-in to Microsoft excel. Analysis done by utilizing multiple regression.
RESULTS: Sixty eight (49 %) were male, mean age was 73.1 years, 91 (66 %) needed mechanical ventilation and 31 (22 %) had positive blood culture. Mean length of MICU stay was 7.7 (range 1-40) days and 106 (77 %) discharged from the MICU alive. Lactate level was elevated in 86 (70 %) and 34 (24.6%) needed pressor(s) after adequate fluid resuscitation. The lactate level correlated with pressor use (p <.0001), dosage of dopamine (p .0006), dosage of norepinephrine (p .0372), mortality (p <.0001), blood culture positivity (p .0001) and duration of MICU confinement/stay (p .0221). It did not correlate need for mechanical ventilation and duration of mechanical ventilation with p values of .146 and .0719 and respectively.
CONCLUSIONS: Lactate level may be a predictor of need for and dosage of pressor, blood culture positivity and length of MICU stay in septic patients in addition to being a predictor of mortality.
CLINICAL IMPLICATIONS: This study raises new possible utility of entry lactate level as predictor of various important Sepsis outcomes.
DISCLOSURE: The following authors have nothing to disclose: Pius Ochieng, Erik Perez, Vincent Rizzo, Ricardo Lopez, Habibur Rahman
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