scholarly journals Correlation between Arterial Lactate and Central Venous Lactate in Children with Sepsis

2016 ◽  
Vol 2016 ◽  
pp. 1-5 ◽  
Author(s):  
Jaime Fernández Sarmiento ◽  
Paula Araque ◽  
María Yepes ◽  
Hernando Mulett ◽  
Ximena Tovar ◽  
...  
Keyword(s):  
Septic Shock ◽  
Blood Sample ◽  
Pediatric Patients ◽  
Venous Blood ◽  
Tissue Perfusion ◽  
Central Venous ◽  
Important Indicator ◽  
Arterial Lactate ◽  
Arterial Blood ◽  
Sepsis And Septic Shock

Introduction. Lactate is an important indicator of tissue perfusion. The objective of this study is to evaluate if there are significant differences between the arterial and central venous measurement of lactate in pediatric patients with sepsis and/or septic shock.Methods. Longitudinal retrospective observational study. Forty-two patients were included between the age of 1 month and 17 years, with a diagnosis of sepsis and septic shock, who were admitted to the intensive care unit of a university referral hospital. The lactate value obtained from an arterial blood sample and a central venous blood sample drawn simultaneously, and within 24 hours of admission to the unit, was recorded.Results. The median age was 2.3 years (RIC 0,3–15), with a predominance of males (71.4%), having a 2.5 : 1 ratio to females. Most of the patients had septic shock (78.5%) of pulmonary origin (50.0%), followed by those of gastrointestinal origin (26.1%). Using Spearman’s Rho, a 0.872 (p<0.001) correlation was found between arterial and venous lactate, which did not vary when adjusted for age (p<0.05) and the use of vasoactive drugs (p<0.05).Conclusion. There is a good correlation between arterial and venous lactate in pediatric patients with sepsis and septic shock, which is not affected by demographic variables or type of vasoactive support.

Diagnostic Validity of Ratio between Differences of Central Venous to Arterial CO2 and Arterial to Central Venous O2 Content in Diagnosis of Anaerobic Metabolism among Septic Patients

2021 ◽  
Vol 8 (1) ◽  
pp. 34-38
Author(s):  
Subroto Kumar Sarker ◽  
Umme Kulsum Choudhury ◽  
Mohammad Mohsin ◽  
Subrata Kumar Mondal ◽  
Muslema Begum
Keyword(s):  
Septic Shock ◽  
Severe Sepsis ◽  
Intensive Care ◽  
Anaerobic Metabolism ◽  
Venous Blood ◽  
Blood Gases ◽  
Serum Lactate ◽  
Central Venous ◽  
College Hospital ◽  
Sepsis And Septic Shock

Background: Detection of anaerobic metabolism is very crucial for the management of the septic patients. Objective: The purpose of the present study was to validate the ratio between differences of central venous to arterial CO2 and arterial to central venous O2 content in diagnosis of anaerobic metabolism among septic patients. Methodology: This prospective observational study was conducted in the Intensive Care Unit of the department of Anaesthesia Analgesia, Palliative and Intensive Care Medicine at Dhaka Medical College Hospital, Dhaka, Bangladesh from January 2016 to December 2016. All patients admitted to ICU with the features of severe sepsis and septic shock according to SSC guidelines with the age of more than or equal to 18 years in both sexes were included in this study. The arterial and central venous blood gases were measure simultaneously. At the same time serum lactate was measured. Result: Among the 69 patients, 31(44.9%) were of severe sepsis and 38(55%) were of septic shock patients. In the severe sepsis and septic shock patients the mean P(v-a)CO2/C(a-v)O2 is 1.39±0.41 and 1.11±0.40 respectively. Serum lactate in case of severe sepsis and septic shock patients is 2.85±1.40 and 3.85±1.04 respectively. The ROC analysis showed an area under curve 0.89 and P(v-a)CO2/C(a-v)O2 ratio cutoff value of 1.21 showed sensitivity 0.84 and specificity 0.94. Conclusion: The P(v-a)CO2/C(a-v)O2  ratio is also a another marker of global anaerobic metabolism and it would be used for diagnosis as well as management of septic patient.  Journal of Current and Advance Medical Research, January 2021;8(1):34-38

scholarly journals Lactate levels from arterial, central venous and peripheral venous blood in severe sepsis and septic shock patients

Critical Care ◽  
2007 ◽  
Vol 11 (Suppl 2) ◽  
pp. P452 ◽  
Author(s):  
M Assuncao ◽  
A Nascente ◽  
C Guedes ◽  
B Mazza ◽  
M Jacki ◽  
...  
Keyword(s):  
Septic Shock ◽  
Severe Sepsis ◽  
Venous Blood ◽  
Central Venous ◽  
Peripheral Venous Blood ◽  
Lactate Levels ◽  
Sepsis And Septic Shock

scholarly journals Selection of blood sampling source to measure lactate levels in patients with septic shock

2021 ◽  
Vol 16 (7-8) ◽  
pp. 75-78
Author(s):  
Tinglan Zuo ◽  
F.S. Glumcher ◽  
S.O. Dubrov
Keyword(s):  
Septic Shock ◽  
Blood Lactate ◽  
Predictive Value ◽  
Lactate Level ◽  
Venous Blood ◽  
Central Vein ◽  
Central Venous ◽  
Central Venous Blood ◽  
Arterial Blood ◽  
Lactate Levels

The initial lactate level has been used as one of mortality predictors in patients with septic shock. Different studies measured the concentrations of blood lactate obtained from different vessels. Even in some retrospective studies, blood lactate levels from heterogeneous sources (artery, central vein, and peripheral vein) have been used. Practicing physicians face following questions: what data have the best predictive value, can they replace each other? In our observations, а high positive linear correlation was found between lactate concentrations in arterial and central venous blood (R = 0.895; P < 0.001). Both indicators have satisfactory values for predicting treatment outcome. Lactate level in arterial blood had a slightly better predictive value compared to its concentration in central venous blood.

scholarly journals SOFA Score, Hemodynamics and Body Temperature Allow Early Discrimination between Porcine Peritonitis-Induced Sepsis and Peritonitis-Induced Septic Shock

2021 ◽  
Vol 11 (3) ◽  
pp. 164
Author(s):  
Mahmoud Al-Obeidallah ◽  
Dagmar Jarkovská ◽  
Lenka Valešová ◽  
Jan Horák ◽  
Jan Jedlička ◽  
...  
Keyword(s):  
Septic Shock ◽  
Body Temperature ◽  
Sofa Score ◽  
Porcine Model ◽  
Venous Blood ◽  
Mixed Venous Blood ◽  
Mechanically Ventilated ◽  
Multiple Parameters ◽  
Failure Assessment ◽  
Sepsis And Septic Shock

Porcine model of peritonitis-induced sepsis is a well-established clinically relevant model of human disease. Interindividual variability of the response often complicates the interpretation of findings. To better understand the biological basis of the disease variability, the progression of the disease was compared between animals with sepsis and septic shock. Peritonitis was induced by inoculation of autologous feces in fifteen anesthetized, mechanically ventilated and surgically instrumented pigs and continued for 24 h. Cardiovascular and biochemical parameters were collected at baseline (just before peritonitis induction), 12 h, 18 h and 24 h (end of the experiment) after induction of peritonitis. Analysis of multiple parameters revealed the earliest significant differences between sepsis and septic shock groups in the sequential organ failure assessment (SOFA) score, systemic vascular resistance, partial pressure of oxygen in mixed venous blood and body temperature. Other significant functional differences developed later in the course of the disease. The data indicate that SOFA score, hemodynamical parameters and body temperature discriminate early between sepsis and septic shock in a clinically relevant porcine model. Early pronounced alterations of these parameters may herald a progression of the disease toward irreversible septic shock.

OPTIMAL CENTRAL VENOUS PRESSURE IN FLUID CHALLENGE IN SEVERE SEPSIS AND SEPTIC SHOCK.

2005 ◽  
Vol 33 ◽  
pp. A166
Author(s):  
Bogdan N Dobrin ◽  
Giulia Soldati ◽  
Marc Van Nuffelen ◽  
Jean-Louis Vincent
Keyword(s):  
Septic Shock ◽  
Severe Sepsis ◽  
Central Venous Pressure ◽  
Venous Pressure ◽  
Fluid Challenge ◽  
Central Venous ◽  
Sepsis And Septic Shock

Comparison between Crystalloid Versus Colloid in Septic Shock

QJM ◽  
2021 ◽  
Vol 114 (Supplement_1) ◽  
Author(s):  
Mohamed Ahmed Mahmoud Amer ◽  
Moheb Shraby Eskander ◽  
Fady Markos Ryad
Keyword(s):  
Septic Shock ◽  
Fluid Resuscitation ◽  
Data Extraction ◽  
Tissue Perfusion ◽  
Patient Centered ◽  
Eligibility Criteria ◽  
Specific Patient ◽  
Acid Base Equilibrium ◽  
Sepsis And Septic Shock ◽  
Balanced Solutions

Abstract Background Fluid resuscitation is a critical component to the emergency department (ED) management of patients with sepsis and septic shock. Fluids are administered to patients with sepsis in order to augment cardiac output and improve tissue perfusion and oxygenation. Recent evidence has suggested that the composition of fluids used in sepsis resuscitation may affect patient-centered outcomes. Objective To systematically review the effects of colloids compared with crystalloids in fluid resuscitation for septic shock. Data Sources Medline databases (PubMed, Medscape, ScienceDirect. EMF-Portal) and all materials available in the Internet till 2017. Data Extraction If the studies did not fulfill the inclusion criteria, they were excluded. Study quality assessment included whether ethical approval was gained, eligibility criteria specified, appropriate controls, and adequate information and defined assessment measures. Conclusion In contrast to 0.9% NS, balanced crystalloid solutions contain significantly lower concentrations of chloride. Instead of large amounts of chloride, balanced solutions contain organic anions (i.e., lactate, gluconate, citrate, acetate) which act as physiologic buffers and are rapidly converted to bicarbonate upon administration. In addition, balanced solutions have less of an adverse effect on acid-base equilibrium than 0.9% NS. Balanced solutions also contain varying amounts of cations (i.e., potassium, calcium). Many critically ill patients across the world receive HES solutions for resuscitation. HES solutions are defined by their molecular weight and degree of hydroxyethylation. Recent evidence has demonstrated significant harm with the use of HES solutions. The administration of albumin in the critical patient is not associated to demonstrated adverse effects, though it should be reserved for specific patient groups in which it has been shown to offer benefit.

Comparative study of bedside and laboratory measurements of hemoglobin

1996 ◽  
Vol 5 (6) ◽  
pp. 427-432 ◽  
Author(s):  
DA Krenzischek ◽  
FV Tanseco
Keyword(s):  
Venous Blood ◽  
Hemoglobin Level ◽  
Johns Hopkins Hospital ◽  
Postanesthesia Care Unit ◽  
Laboratory Measurements ◽  
Central Venous ◽  
Blood Samples ◽  
Central Venous Blood ◽  
Arterial Blood ◽  
Group I

OBJECTIVE: The purpose of this study was to examine the effects of variations in technique on measurements of hemoglobin level done at the bedside and to compare these results with laboratory measurements of hemoglobin. DESIGN: In accordance with hospital policy, procedure, and protocol, various techniques were used to obtain samples of capillary and venous blood and of blood from arterial and central venous catheters. Levels of hemoglobin were measured at the bedside and in the laboratory, and the results were compared. SETTING: The Johns Hopkins Hospital adult postanesthesia care unit. SAMPLE: A total of 187 blood samples were obtained from 62 adults who had undergone general surgery. Group I comprised 20 subjects with capillary and venous blood samples. Group II comprised 21 subjects with arterial blood samples. Group III comprised 21 subjects with central venous blood samples. RESULTS: The results showed that the amount of blood to be discarded before obtaining samples of arterial and central venous blood need not be any larger than double the dead space of the catheter, and that shaking the blood sample for 10 seconds was sufficient to mix the sample before measurement of hemoglobin levels. Results of bedside and laboratory measurements of hemoglobin level were comparable. CONCLUSION: Bedside measurement of hemoglobin increases efficiency in patient care, decreases risk of blood-transmitted infection for staff, and decreases cost to the patient. However, the persons who perform the assay must be responsible in adhering to the standard of practice to minimize errors in the measurements.

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