Prognostic significance of plasma lactate levels on admission in non-immune travellers with various species of imported malaria

2006 ◽  
Vol 17 (3-4) ◽  
pp. 125-128
Author(s):  
Perry J. J. van Genderen ◽  
Rien Dekkers ◽  
Dennis A. Hesselink ◽  
Tom van Gool ◽  
Pieter L. Petit ◽  
...  
2006 ◽  
Vol 17 (3) ◽  
pp. 125-128
Author(s):  
Perry van Genderen ◽  
Rien Dekkers ◽  
Dennis Hesselink ◽  
Tom van Gool ◽  
Pieter Petit ◽  
...  

1978 ◽  
Vol 56 (4) ◽  
pp. 578-584 ◽  
Author(s):  
E. Hohtola ◽  
H. Rintamäki ◽  
R. Hissa

A dose-controlled chemical sympathectomy with 6-hydroxydopamine (6-OHDA) did not disrupt thermostasis in the pigeon at +38 °C. At +6 °C, thermogenesis was impaired, but the lower body temperature and oxygen consumption were stable and vasoconstriction was normal. The stability may partly be explained by a massive release of adrenaline from the adrenals (50% in 20 min). Despite a deficit in heat production both after sympathectomy and after acute 6-OHDA, no change in muscle electrical activity was observed. Plasma free fatty acid (FFA) concentration was significantly elevated after sympathectomy, but no changes occurred in blood glucose or plasma lactate levels. The results indicate a major compensatory role for the adrenals in avian thermogenesis. They also suggest a sympathetically mediated auxiliary thermogenic mechanism independent of muscle electrical activity and coupled to FFA metabolism.


1993 ◽  
Vol 264 (6) ◽  
pp. E943-E950 ◽  
Author(s):  
A. A. Young ◽  
G. J. Cooper ◽  
P. Carlo ◽  
T. J. Rink ◽  
M. W. Wang

The actions of intravenous glucagon and amylin, a newly discovered hyperglycemic pancreatic islet hormone, have been compared in 20-h fasted and fed, lightly anesthetized rats, and in rats made hypoglycemic with an insulin infusion. In fasted animals, amylin (75 nmol/kg) was more effective than glucagon (90 nmol/kg) in increasing plasma glucose (glucose increment 4.55 vs. 1.71 mM, P < 0.001). Amylin elicited a marked increase in plasma lactate, as previously reported, whereas glucagon did not alter plasma lactate. In fed animals, glucagon elicited twice as much increase in plasma glucose as did amylin; amylin again elicited a marked lactate increase that was greater (increment 1.45 vs. 0.97 mM, P < 0.05) and more prolonged than in the fasted state, whereas glucagon was without effect on lactate levels. These findings are consistent with glucagon's known action to promote hyperglycemia from hepatic glycogenolysis and amylin's demonstrated action to promote muscle glycogenolysis and increase lactate supply to the liver. Infusions of sodium lactate that produced plasma lactate increments similar to those evoked by 75 nmol/kg amylin evoked patterns of glucose response in fasted and fed rats similar to those evoked by amylin. Thus increased lactate supply to the liver may account for amylin's hyperglycemic effects. Amylin and glucagon could each restore plasma glucose to control levels in fasted animals made hypoglycemic by insulin infusion (plasma glucose reduced to 3.3 mM). A bolus of 75 nmol/kg amylin was more effective than 180 nmol/kg glucagon, restoring basal glucose levels for > 3 h, whereas glucagon restored it for < 1 h.(ABSTRACT TRUNCATED AT 250 WORDS)


2020 ◽  
Vol 7 (6) ◽  
pp. 1213
Author(s):  
Rashmi Patil ◽  
Chikkanarasareddy P. S. ◽  
Mallesh K.

Background: Severe sepsis and septic shock are the major causes of admission and deaths in the ICU, killing one in four (and often more) and increasing in incidence. In order to improve the clinical outcomes in these patients, it is crucial to obtain early recognition of patients who are at risk of death and to optimize the clinical decision making in a timely manner. In order to monitor the metabolic consequences of shock and hemodynamic management, plasma lactate levels can be used in critical illness. Objective of the study is to estimate plasma lactate and lactate clearance in sepsis and septic shock patients and to correlate plasma lactate and lactate clearance as predictors of mortality.Methods: This study is a prospective observational study conducted over 18months. Children with age of 1 month to 18 years admitted to the Paediatric intensive care unit with sepsis and septic shock were enrolled in the study. ABG at admission to document plasma lactate and lactate repeated at 6 and 24 hrs. Lactate clearance calculated at 6 and 24 hrs. The final outcome in terms of survival or death will be recorded.Results: Majority of the children fall in the class between 1-6 months 51(48.11%). Male comprises 69(65.09%). Among these, Sepsis 36(33.96%); followed by Pneumonia 34(32.07%). Survivors group were 35(33.02%) and non-survivor was 71(66.98%). The Non survivor group was observed to have lower mean values of lactate clearance and found to be statistically significant. Specificity of Lactate clearance was 63.52% and Sensitivity 76.02% respectively. The results were positively associated with lactate level at 24 hours found to be significant effect of survivability when compared to non-survivor.Conclusions: Lactate clearance is vital and markable sign for screening of septic shock at early stage for therapeutic option. Further, 24-hours lactate estimation (cut off values) clearance appears superior to 6 h lactate clearance in predicting mortality in such patients.


2020 ◽  
Vol 8 (1) ◽  
pp. e001457
Author(s):  
Jiun-Ruey Hu ◽  
Yingfei Wu ◽  
Frank M Sacks ◽  
Lawrence J Appel ◽  
Edgar R Miller III ◽  
...  

IntroductionPlasma lactate is a marker of non-oxidative glucose metabolism associated with progression to diabetes. We examined the effect of carbohydrate quality (glycemic index (GI)) and amount (%kcal) on plasma lactate. We hypothesized that low GI (≤45 (g)) versus high (≥65 (G)) and low %kcal from carbohydrate (40% kcal (c)) versus high (58% kcal (C)) each would reduce lactate levels.Research design and methodsWe measured lactate in OmniCarb, a randomized, cross-over trial of four diets in overweight/obese adults without diabetes or cardiovascular disease (N=163). The four diets were high carbohydrate+high GI (CG, reference), high carbohydrate+low GI (Cg), low carbohydrate+high GI (cG), and low carbohydrate+low GI (cg). Participants (N=163) consumed each of the four diets over a 5-week period, separated by 2-week washout periods. Plasma lactate levels were measured at baseline, during which the participants consumed their own diets, and after each 5-week period.ResultsBaseline plasma lactate was 1.2 mmol/L. In the setting of high carbohydrate amount, reducing GI lowered plasma lactate non-significantly by 0.08 mmol/L (Cg vs CG: 95% CI −0.16 to 0.00; p=0.06). In the setting of high GI, reducing carbohydrate amount lowered plasma lactate by 0.10 mmol/L (cG vs CG: 95% CI −0.19 to −0.02; p=0.02). The combined effect of reducing GI and carbohydrate proportion in the diet (cg vs CG) was similar (cg vs CG: −0.08; 95% CI −0.16 to 0.00; p=0.04). All four diets reduced plasma lactate compared with baseline.ConclusionsCompared with a diet with high GI and high carbohydrate amount, diets with low GI and/or low carbohydrate amount reduced plasma lactate. Whether this change in lactate leads to long-term change in glucose metabolism needs to be examined.Trial registration numberNCT00608049.


1992 ◽  
Vol 1 (6) ◽  
pp. 419-423 ◽  
Author(s):  
A. Beishuizen ◽  
J. M. Götz ◽  
L. Kip ◽  
C. Haanen ◽  
I. Vermes

Immunoreactive endothelin (ETi) and atrial natriuretic peptide (ANPi) blood levels were measured by radioimmunoassay in patients with clinically defined sepsis. The interaction between these two peptides and their relation to circulatory shock and mortality were studied. All septic patients (n = 16) had significantly higher ETi (22.3 ± 11.1 pg/ml) and ANPi (398.3 ± 154.3 pg/ml) plasma concentrations compared to control subjects (ETi, 4.1 ± 1.2; ANPi, 59.1 ± 14.8 pg/ml; n = 13). ETi levels followed the severity of illness according to the APACHE II scoring system and were higher in patients who did not survive. ETi levels were significantly higher in the presence of shock and bacteraemia. Furthermore, ETi correlated well with plasma lactate (r = 0.83, p < 0.05), but not with renal function. ANPi levels did not show correlation with any of these determinants. Serial blood sampling, six consecutive days after admission, showed that ETi levels gradually decreased in normotensive patients in contrast to patients with septic shock. ANPi levels did not show systematic changes in time, and no relationship was observed between ETi and ANPi levels. These results suggest that plasma ETi levels are indicative for disease severity and might have prognostic significance. The role of ANPi during sepsis remains to be eludicated.


Author(s):  
Stephen R. Stannard ◽  
Martin W. Thompson ◽  
Janette C. Brand Miller

Consumption of low glycemic index (GI) foods before submaximal endurance exercise may be beneficial to performance. To test whether this may also be true for high intensity exercise. 10 trained cyclists began an incremental exercise test to exhaustion 65 min after consuming equal carbohydrate portions of glucose (HGI), pasta (LGI), and a noncarbohydrate control (PL). Time to fatigue did not differ significantly (p = 0.05) between treatments. Plasma glucose concentration was significantly lower after LGI vs. HGI from 15 to 45 min of rest postprandial. During exercise, plasma glucose concentration was significantly lower after HGI vs. LGI from 200 W until exhaustion. Plasma lactate concentration following HGI was significantly higher than PL from 30 min of rest postprandial through to the end of the 200-W workload. Plasma lactate concentration following LGI was significantly lower than after HGI from 45 min of rest postprandial through to the end of the 100-W workload. At higher exercise intensities, there was no significant difference in plasma lactate levels between treatments. These findings suggest that a high GI carbohydrate meal (1 g/kg body wt) 65 min prior to exercise decreases plasma glucose and increases plasma lactate levels compared to a low GI meal, but not enough to be detrimental to incremental exercise performance.


1958 ◽  
Vol 192 (3) ◽  
pp. 585-591 ◽  
Author(s):  
Norman R. Alpert ◽  
Herbert Kayne ◽  
Winona Haslett

An experiment was designed to test the ‘O2debt’ hypothesis. Oxygen consumption and plasma lactate were measured before, during and following hypoixa in unanesthetized spinally transected dogs. The O2 consumption was depressed during hypoxia and returned toward control levels during recovery. Lactate levels increased during the hypoxia and returned to the control during recovery. Oxygen missed was correlated with the excess consumption of recovery. A highly significant relationship was found which indicated that the larger the depression in O2 consumption during hypoxia, the greater was the depression during the recovery period and the more prolonged the return to control levels. Oxygen missed during hypoxia was compared to lactate production. A significant relationship was found. Lactate removal was compared to excess consumption of recovery. No correlation existed between lactate removal and recovery O2 consumption. The authors postulate the presence of a metabolic governor which controls the rate of O2 uptake.


2019 ◽  
Vol 8 (12) ◽  
pp. 2218 ◽  
Author(s):  
Fausto Biancari ◽  
Antonio Fiore ◽  
Kristján Jónsson ◽  
Giuseppe Gatti ◽  
Svante Zipfel ◽  
...  

Background: The outcome after weaning from postcardiotomy venoarterial extracorporeal membrane oxygenation (VA-ECMO) is poor. In this study, we investigated the prognostic impact of arterial lactate levels at the time of weaning from postcardiotomy VA. Methods: This analysis included 338 patients from the multicenter PC-ECMO registry with available data on arterial lactate levels at weaning from VA-ECMO. Results: Arterial lactate levels at weaning from VA-ECMO (adjusted OR 1.426, 95%CI 1.157–1.758) was an independent predictor of hospital mortality, and its best cutoff values was 1.6 mmol/L (<1.6 mmol/L, 26.2% vs. ≥ 1.6 mmol/L, 45.0%; adjusted OR 2.489, 95%CI 1.374–4.505). When 261 patients with arterial lactate at VA-ECMO weaning ≤2.0 mmol/L were analyzed, a cutoff of arterial lactate of 1.4 mmol/L for prediction of hospital mortality was identified (<1.4 mmol/L, 24.2% vs. ≥1.4 mmol/L, 38.5%, p = 0.014). Among 87 propensity score-matched pairs, hospital mortality was significantly higher in patients with arterial lactate ≥1.4 mmol/L (39.1% vs. 23.0%, p = 0.029) compared to those with lower arterial lactate. Conclusions: Increased arterial lactate levels at the time of weaning from postcardiotomy VA-ECMO increases significantly the risk of hospital mortality. Arterial lactate may be useful in guiding optimal timing of VA-ECMO weaning.


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