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 The Effect of Frailty on 30‐day Mortality Risk in Older Patients With Acute Heart Failure Attended in the Emergency Department

2017 ◽  
Vol 24 (3) ◽  
pp. 298-307 ◽  
Author(s):  
Francisco Javier Martín‐Sánchez ◽  
Esther Rodríguez‐Adrada ◽  
Christian Mueller ◽  
María Teresa Vidán ◽  
Michael Christ ◽  
...  
Keyword(s):  
Heart Failure ◽  
Emergency Department ◽  
Acute Heart Failure ◽  
Mortality Risk ◽  
Older Patients

Multicentric investigation of survival after Spanish emergency department discharge for acute heart failure

2012 ◽  
Vol 19 (3) ◽  
pp. 153-160 ◽  
Author(s):  
Òscar Miró ◽  
Víctor Gil ◽  
Pablo Herrero ◽  
Francisco Javier Martín-Sánchez ◽  
Javier Jacob ◽  
...  
Keyword(s):  
Heart Failure ◽  
Emergency Department ◽  
Acute Heart Failure ◽  
Emergency Department Discharge

Predicting the risk of reattendance for acute heart failure patients discharged from Spanish Emergency Department observation units

2010 ◽  
Vol 17 (4) ◽  
pp. 197-202 ◽  
Author(s):  
Òscar Miró ◽  
Pere Llorens ◽  
Francisco Javier Martín-Sánchez ◽  
Pablo Herrero ◽  
Javier Jacob ◽  
...  
Keyword(s):  
Heart Failure ◽  
Emergency Department ◽  
Acute Heart Failure ◽  
Heart Failure Patients ◽  
Observation Units

scholarly journals Refractory Lactic Acidosis in Small Cell Carcinoma of the Lung

2017 ◽  
Vol 2017 ◽  
pp. 1-3 ◽  
Author(s):  
Daniel J. Oh ◽  
Ellen Dinerman ◽  
Andrew H. Matthews ◽  
Abraham W. Aron ◽  
Katherine M. Berg
Keyword(s):  
Lactic Acidosis ◽  
Cell Carcinoma ◽  
Critically Ill ◽  
Small Cell Carcinoma ◽  
Small Cell ◽  
Critically Ill Patient ◽  
Caucasian Woman ◽  
Tissue Hypoperfusion ◽  
Lactate Levels ◽  
Elevated Lactate

Background. Elevated lactate levels in critically ill patients are most often thought to be indicative of relative tissue hypoxia or type A lactic acidosis. Shock, severe anemia, and thromboembolic events can all cause elevated lactate due to tissue hypoperfusion, as well as the mitochondrial dysfunction thought to occur in sepsis and other critically ill states. Malignancy can also lead to elevation in lactate, a phenomenon described as type B lactic acidosis, which is much less commonly encountered in the critically ill. Case Presentation. We present the case of a 73-year-old Caucasian woman with type 2 diabetes and hypertension who presented with abdominal pain, nausea, vomiting, nonbloody diarrhea, and weight loss over five weeks and was found to have unexplained refractory lactic acidosis despite fluids and antibiotics. She was later diagnosed with small cell carcinoma of the lung. Conclusions. In this case report, we describe a critically ill patient whose elevated lactate was incorrectly attributed to her acute illness, when in truth it was an indicator of an underlying, as yet undiagnosed, malignancy. We believe this case is instructive to the critical care clinician as a reminder of the importance of considering malignancy on the differential diagnosis of a patient presenting with elevated lactate out of proportion to their critical illness.

Sign in / Sign up

Export Citation Format

Share Document