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2015 ; 3
(ä): 39
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Lactate kinetics in sepsis and septic shock: a review of the literature and
rationale for further research
#MMPMID26445673
Chertoff J
; Chisum M
; Garcia B
; Lascano J
J Intensive Care
2015[]; 3
(ä): 39
PMID26445673
show ga
Over the last two decades, there have been vast improvements in sepsis-related
outcomes, largely resulting from the widespread adoption of aggressive fluid
resuscitation and infection control. With increased understanding of the
pathophysiology of sepsis, novel diagnostics and resuscitative interventions are
being discovered. In recent years, few diagnostic tests like lactate have
engendered more attention and research in the sepsis arena. Studies highlighting
lactate's prognostic potential for mortality and other outcomes are ubiquitous
and largely focus on the early stage of sepsis management, defined as the initial
6 h and widely referred to as the "golden hours." Additional investigations,
although more representative of surgical and trauma patients, suggest that
lactate measurements beyond 24 h from the initiation of resuscitation continue to
have predictive and prognostic utility. This review summarizes the current
research and evidence regarding lactate's utility as a prognosticator of clinical
outcomes in both early and late sepsis management, defines the mechanism of
lactate production and clearance, and identifies areas warranting further
research.