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10.1513/AnnalsATS.201304-099OC http://scihub22266oqcxt.onion/10.1513/AnnalsATS.201304-099OC C5475420!5475420!24004068     free     free     free Deprecated: Implicit conversion from float 209.6 to int loses precision in C:\Inetpub\vhosts\kidney.de\httpdocs\pget.php on line 534 Deprecated: Implicit conversion from float 209.6 to int loses precision in C:\Inetpub\vhosts\kidney.de\httpdocs\pget.php on line 534 Deprecated: Implicit conversion from float 209.6 to int loses precision in C:\Inetpub\vhosts\kidney.de\httpdocs\pget.php on line 534 Deprecated: Implicit conversion from float 209.6 to int loses precision in C:\Inetpub\vhosts\kidney.de\httpdocs\pget.php on line 534 Deprecated: Implicit conversion from float 209.6 to int loses precision in C:\Inetpub\vhosts\kidney.de\httpdocs\pget.php on line 534       Ann+Am+Thorac+Soc 2013 ; 10 (5): 466-73 Nephropedia Template TP {{tp|p=24004068|t=2013. Fluid Volume, Lactate Values, and Mortality in Sepsis Patients with Intermediate Lactate Values |pdf=|usr=}}{{24004068}} gab.com Text Fluid Volume, Lactate Values, and Mortality in Sepsis Patients with Intermediate Lactate Values JO: Ann Am Thorac Soc http://www.kidney.de/pget.php?&tw=1&pmid=24004068 #FOAvip Rationale: Patients with severe sepsis without shock or tissue hypoperfusion face substantial mortality; however, treatment guidelines are lacking.Objectives: To evaluate the association between intravenous fluid resuscitation, lactate clearance, and mortality in patients with ?intermediate? lactate values of 2 mmol/L or greater and less than 4 mmol/L.Measurements and Main Results: This was a retrospective study of 9,190 patients with sepsis with intermediate lactate values. Interval changes between index lactate values and those at 4, 8, and 12 hours were calculated with corresponding weight-based fluid volumes. Outcomes included lactate change and mortality. Repeat lactate tests were completed in 94.7% of patients within 12 hours. Hospital and 30-day mortality were 8.2 and 13.3%, respectively, for patients with lactate clearance; they were 18.7 and 24.7%, respectively, for those without lactate clearance. Each 10% increase in repeat lactate values was associated with a 9.4% (95% confidence interval [CI] = 7.8?11.1%) increase in the odds of hospital death. Within 4 hours, patients received 32 (±18) ml/kg of fluid. Each 7.5 ml/kg increase was associated with a 1.3% (95% CI = 0.6?2.1%) decrease in repeat lactate. Across an unrestricted range, increased fluid was not associated with improved mortality. However, when limited to less than 45 ml/kg, additional fluid was associated with a trend toward improved survival (odds ratio = 0.92; 95% CI = 0.82?1.03) that was statistically significant among patients with highly concordant fluid records.Conclusions: Early fluid administration, below 45 ml/kg, was associated with modest improvements in lactate clearance and potential improvements in mortality. Further study is needed to define treatment strategies in this prevalent and morbid group of patients with sepsis. Twit Text FOAVip Fluid Volume, Lactate Values, and Mortality in Sepsis Patients with Intermediate Lactate Values ????Ann Am Thorac Soc http://www.kidney.de/pget.php?&tw=1&pmid=24004068 #FOAvip Twit Text # Free Paper on # # # # # LINK http://www.kidney.de/pget.php?&tw=1&pmid=24004068 #FOAvip English Wikipedia <ref>{{Cite pmid|24004068}}</ref> Fluid Volume, Lactate Values, and Mortality in Sepsis Patients with Intermediate Lactate Values #MMPMID24004068 Liu V; Morehouse JW; Soule J; Whippy A; Escobar GJ Ann Am Thorac Soc 2013[Oct]; 10 (5): 466-73 PMID24004068show ga Rationale: Patients with severe sepsis without shock or tissue hypoperfusion face substantial mortality; however, treatment guidelines are lacking.Objectives: To evaluate the association between intravenous fluid resuscitation, lactate clearance, and mortality in patients with ?intermediate? lactate values of 2 mmol/L or greater and less than 4 mmol/L.Measurements and Main Results: This was a retrospective study of 9,190 patients with sepsis with intermediate lactate values. Interval changes between index lactate values and those at 4, 8, and 12 hours were calculated with corresponding weight-based fluid volumes. Outcomes included lactate change and mortality. Repeat lactate tests were completed in 94.7% of patients within 12 hours. Hospital and 30-day mortality were 8.2 and 13.3%, respectively, for patients with lactate clearance; they were 18.7 and 24.7%, respectively, for those without lactate clearance. Each 10% increase in repeat lactate values was associated with a 9.4% (95% confidence interval [CI] = 7.8?11.1%) increase in the odds of hospital death. Within 4 hours, patients received 32 (±18) ml/kg of fluid. Each 7.5 ml/kg increase was associated with a 1.3% (95% CI = 0.6?2.1%) decrease in repeat lactate. Across an unrestricted range, increased fluid was not associated with improved mortality. However, when limited to less than 45 ml/kg, additional fluid was associated with a trend toward improved survival (odds ratio = 0.92; 95% CI = 0.82?1.03) that was statistically significant among patients with highly concordant fluid records.Conclusions: Early fluid administration, below 45 ml/kg, was associated with modest improvements in lactate clearance and potential improvements in mortality. Further study is needed to define treatment strategies in this prevalent and morbid group of patients with sepsis. äFluid Volume, Lactate Values, and Mortality in Sepsis Patients with In(epmc).pdf DeepDyve Pubget Overpricing