scholarly journals The Case | Elevated lactate and osmolar gap after levothyroxine overdose

2015 ◽  
Vol 88 (2) ◽  
pp. 419-420 ◽  
Author(s):  
Gary D. Rothberger ◽  
Anish K. Desai ◽  
Sairah Sharif ◽  
Shalinee A. Chawla ◽  
Shayan Shirazian
Keyword(s):  
Osmolar Gap ◽  
Elevated Lactate

229-LB: Plasma Lactate and Muscle Aerobic Substrate Oxidation: Does Elevated Lactate Precede Obesity?

Diabetes ◽  
2020 ◽  
Vol 69 (Supplement 1) ◽  
pp. 229-LB
Author(s):  
NICHOLAS T. BROSKEY ◽  
TERRY E. JONES ◽  
ZHEN YANG ◽  
NKAUJYI KHANG ◽  
DONGHAI ZHENG ◽  
...  
Keyword(s):  
Substrate Oxidation ◽  
Plasma Lactate ◽  
Elevated Lactate

Predictors of Mortality Among Very Low Birth Weight Infants With Gastrointestinal Perforation

2020 ◽  
pp. 000313482095692
Author(s):  
Marina L. Reppucci ◽  
Eliza H. Hersh ◽  
Prerna Khetan ◽  
Brian A. Coakley
Keyword(s):  
Metabolic Acidosis ◽  
Birth Weight ◽  
Low Birth Weight ◽  
Very Low Birth Weight ◽  
Severe Metabolic Acidosis ◽  
Related Factors ◽  
Vlbw Infants ◽  
Risk Of Death ◽  
Portal Venous Gas ◽  
Elevated Lactate

Background Gastrointestinal (GI) perforation is a risk factor for mortality in very low birth weight (VLBW) infants. Little data exist regarding pretreatment factors and patient characteristics known to independently correlate with risk of death. Materials and Methods A retrospective review of all VLBW infants who sustained GI perforation between 2011 and 2018 was conducted. Birth, laboratory, and disease-related factors of infants who died were compared to those who survived. Results 42 VLBW infants who sustained GI perforations were identified. Eleven (26.19%) died. There were no significant differences in birth-related factors, hematological lab levels at diagnosis, presence of pneumatosis, or bacteremia. Portal venous gas ( P = .03), severe metabolic acidosis ( P < .01), and elevated lactate at diagnosis ( P < .01) were statistically more likely to occur among infants who died. Discussion Portal venous gas, severe metabolic acidosis, and elevated lactate were associated with an increased risk of mortality among VLBW infants who develop a GI perforation. Further research is required to better identify risk factors.

IMPORTANCE OF ELEVATED LACTATE LEVEL WITHOUT CLEAR SEPSIS

CHEST Journal ◽  
2019 ◽  
Vol 156 (4) ◽  
pp. A1700
Author(s):  
Niranjana Chellappa ◽  
Momena Sohail ◽  
Amy Vandenberg ◽  
Anupam Suneja
Keyword(s):  
Lactate Level ◽  
Elevated Lactate ◽  
Elevated Lactate Level

Blood lactate concentration in COVID-19: a systematic literature review

2021 ◽  
Vol 0 (0) ◽  
Author(s):  
Giovanni Carpenè ◽  
Diletta Onorato ◽  
Riccardo Nocini ◽  
Gianmarco Fortunato ◽  
John G. Rizk ◽  
...  
Keyword(s):  
Literature Review ◽  
Blood Lactate ◽  
Systematic Literature Review ◽  
Lactate Concentration ◽  
Blood Lactate Concentration ◽  
Organ Injury ◽  
Respiratory Condition ◽  
Therapeutic Decisions ◽  
Lactate Levels ◽  
Elevated Lactate

Abstract Coronavirus disease 2019 (COVID-19) is an infectious respiratory condition sustained by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), which manifests prevalently as mild to moderate respiratory tract infection. Nevertheless, in a number of cases the clinical course may deteriorate, with onset of end organ injury, systemic dysfunction, thrombosis and ischemia. Given the clinical picture, baseline assessment and serial monitoring of blood lactate concentration may be conceivably useful in COVID-19. We hence performed a systematic literature review to explore the possible association between increased blood lactate levels, disease severity and mortality in COVID-19 patients, including comparison of lactate values between COVID-19 and non-COVID-19 patients. We carried out an electronic search in Medline and Scopus, using the keywords “COVID-19” OR “SARS-CoV-2” AND “lactate” OR “lactic acid” OR “hyperlactatemia”, between 2019 and present time (i.e. October 10, 2021), which allowed to identify 19 studies, totalling 6,459 patients. Overall, we found that COVID-19 patients with worse outcome tend to display higher lactate values than those with better outcome, although most COVID-19 patients in the studies included in our analysis did not have sustained baseline hyperlactatemia. Substantially elevated lactate values were neither consistently present in all COVID-19 patients who developed unfavourable clinical outcomes. These findings suggest that blood lactate monitoring upon admission and throughout hospitalization may be useful for early identification of higher risk of unfavourable COVID-19 illness progression, though therapeutic decisions based on using conventional hyperlactatemia cut-off values (i.e., 2.0 mmol/L) upon first evaluation may be inappropriate in patients with SARS-CoV-2 infection.

scholarly journals Regulation of glycogen phosphorylase and PDH during exercise in human skeletal muscle during hypoxia

2000 ◽  
Vol 278 (3) ◽  
pp. E522-E534 ◽  
Author(s):  
Michelle L. Parolin ◽  
Lawrence L. Spriet ◽  
Eric Hultman ◽  
Melanie G. Hollidge-Horvat ◽  
Norman L. Jones ◽  
...  
Keyword(s):  
Skeletal Muscle ◽  
Glycogen Phosphorylase ◽  
Lactate Production ◽  
Muscle Metabolism ◽  
Lactate Accumulation ◽  
Pyruvate Oxidation ◽  
Reduced Rate ◽  
Rate Limiting ◽  
Muscle Biopsies ◽  
Elevated Lactate

The present study examined the acute effects of hypoxia on the regulation of skeletal muscle metabolism at rest and during 15 min of submaximal exercise. Subjects exercised on two occasions for 15 min at 55% of their normoxic maximal oxygen uptake while breathing 11% O2 (hypoxia) or room air (normoxia). Muscle biopsies were taken at rest and after 1 and 15 min of exercise. At rest, no effects on muscle metabolism were observed in response to hypoxia. In the 1st min of exercise, glycogenolysis was significantly greater in hypoxia compared with normoxia. This small difference in glycogenolysis was associated with a tendency toward a greater concentration of substrate, free Pi, in hypoxia compared with normoxia. Pyruvate dehydrogenase activity (PDHa) was lower in hypoxia at 1 min compared with normoxia, resulting in a reduced rate of pyruvate oxidation and a greater lactate accumulation. During the last 14 min of exercise, glycogenolysis was greater in hypoxia despite a lower mole fraction of phosphorylase a. The greater glycogenolytic rate was maintained posttransformationally through significantly higher free [AMP] and [Pi]. At the end of exercise, PDHawas greater in hypoxia compared with normoxia, contributing to a greater rate of pyruvate oxidation. Because of the higher glycogenolytic rate in hypoxia, the rate of pyruvate production continued to exceed the rate of pyruvate oxidation, resulting in significant lactate accumulation in hypoxia compared with no further lactate accumulation in normoxia. Hence, the elevated lactate production associated with hypoxia at the same absolute workload could in part be explained by the effects of hypoxia on the activities of the rate-limiting enzymes, phosphorylase and PDH, which regulate the rates of pyruvate production and pyruvate oxidation, respectively.

Cause of an Elevated Lactate Level

JAMA ◽  
2015 ◽  
Vol 313 (23) ◽  
pp. 2381
Author(s):  
Kai E. Swenson ◽  
Charles R. Wira
Keyword(s):  
Lactate Level ◽  
Elevated Lactate ◽  
Elevated Lactate Level

scholarly journals Lactate levels as a marker of tissue hypoperfusion in acute heart failure patients seen in the emergency department: a pilot study

2016 ◽  
Vol 1 (1) ◽  
Author(s):  
Kori Sauser ◽  
Lora Alkhawam ◽  
Linda Pierchala ◽  
Peter S. Pang
Keyword(s):  
Heart Failure ◽  
Emergency Department ◽  
Pilot Study ◽  
Acute Heart Failure ◽  
Tissue Ischemia ◽  
Tissue Hypoperfusion ◽  
Baseline Characteristics ◽  
Lactate Levels ◽  
Elevated Lactate ◽  
Mean Heart Rate

Acute heart failure (AHF) may lead to subclinical tissue ischemia due to hypoperfusion from inadequate forward flow or congestion. The aim of the present study is to test whether lactate levels are elevated in emergency department (ED) patients with AHF. A prospective pilot study of ED AHF patients was conducted. Venous lactate level was measured at baseline and 6-12 hours after initial draw. Of the 50 patients enrolled, mean age was 65.3 years, 68% were male. Only 7 (14%) had an elevated lactate on either draw, with no differences in baseline characteristics between patients with and without elevated lactate. Patients with an elevated lactate had a higher mean heart rate (99 <em>vs</em> 81, P=0.03) and trended toward an increased rate of abnormal initial temperature (57 <em>vs</em> 23%, P=0.06). In this pilot study, only a minority of acute HF patients had an elevated lactate on presentation.

scholarly journals Hyperlactacemia in critically ill children: comparison of traditional and Fencl-Stewart methods

2007 ◽  
Vol 47 (1) ◽  
pp. 35
Author(s):  
Hari Kushartono ◽  
Antonius H. Pudjiadi ◽  
Susetyo Harry Purwanto ◽  
Imral Chair ◽  
Darlan Darwis ◽  
...  
Keyword(s):  
Base Excess ◽  
Pediatric Intensive Care ◽  
Blood Gases ◽  
Critically Ill Children ◽  
Strongly Correlated ◽  
Acid Base ◽  
Arterial Blood ◽  
Acid Base Status ◽  
Lactate Levels ◽  
Elevated Lactate

Background Base excess is a single variable used to quantifymetabolic component of acid base status. Several researches havecombined the traditional base excess method with the Stewartmethod for acid base physiology called as Fencl-Stewart method.Objective The purpose of the study was to compare two differentmethods in identifying hyperlactacemia in pediatric patients withcritical illness.Methods The study was performed on 43 patients admitted tothe pediatric intensive care unit of Cipto MangunkusumoHospital, Jakarta. Sodium, potassium, chloride, albumin, lactateand arterial blood gases were measured. All samples were takenfrom artery of all patients. Lactate level of >2 mEq/L was definedas abnormal. Standard base excess (SBE) was calculated fromthe standard bicarbonate derived from Henderson-Hasselbalchequation and reported on the blood gas analyzer. Base excessunmeasured anions (BE UA ) was calculated using the Fencl-Stewartmethod simplified by Story (2003). Correlation between lactatelevels in traditional and Fencl-Stewart methods were measuredby Pearson’s correlation coefficient .Results Elevated lactate levels were found in 24 (55.8%) patients.Lactate levels was more strongly correlated with BE UA (r = - 0.742,P<0.01) than with SBE (r = - 0.516, P<0.01).Conclusion Fencl-Stewart method is better than traditionalmethod in identifying patients with elevated lactate levels, so theFencl-Stewart method is suggested to use in clinical practice.

scholarly journals Ciprofloxacin-Induced Thrombotic Thrombocytopenic Purpura: A Case of Successful Treatment and Review of the Literature

2015 ◽  
Vol 2015 ◽  
pp. 1-4
Author(s):  
Hafiz Rizwan Talib Hashmi ◽  
Gilda Diaz-Fuentes ◽  
Preeti Jadhav ◽  
Misbahuddin Khaja
Keyword(s):  
Thrombotic Thrombocytopenic Purpura ◽  
African American Woman ◽  
American Woman ◽  
Successful Outcome ◽  
Peripheral Smear ◽  
Thrombocytopenic Purpura ◽  
Aggressive Management ◽  
First Case ◽  
High Index Of Suspicion ◽  
Elevated Lactate

A 49-year-old African American woman was admitted to our hospital with abdominal pain, nausea, vomiting, lethargy, and confusion. She was receiving ciprofloxacin for a urinary-tract infection prior to admission. Laboratory examination revealed anemia, thrombocytopenia, elevated lactate dehydrogenase, and serum creatinine. Peripheral smear showed numerous schistocytes, and the patient was diagnosed with thrombotic thrombocytopenic purpura (TTP). Ciprofloxacin was identified as the offending agent. The patient received treatment with steroids and plasmapheresis, which led to rapid clinical recovery. This is the first case to our knowledge of successfully treated ciprofloxacin-induced TTP; previously reported cases had fulminant outcomes. Quinolones are an important part of the antibiotic armamentarium, and this case can raise awareness of the association between quinolones and TTP. A high index of suspicion for detection and early and aggressive management are vitally important for a successful outcome.

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