What is the lactate level for severe sepsis?

Although the current guidelines for severe sepsis and septic shock resuscitation recommend that patients with severe sepsis or septic shock with an initial blood lactate level of at least 4.0 mmol/L must be promptly resuscitated (15), recent studies have shown that less expressive elevations in lactate levels have also …

Can lactic acidosis cause death?

When increased production is comorbid with decreased clearance, the severity of the clinical course escalates. Importantly, the effects of severely elevated levels of lactic acid can have profound hemodynamic consequences and can lead to death.

What are the odds of death from lactic acid?

Lactate level was strongly associated with mortality. The study used a lactate level of <2.5 mmol/L as the reference group: Unadjusted odds of death (lactate level 2.5 – 4.0 mmol/L) = 2.7 Unadjusted odds of death (lactate level ≥4 mmol/L) = 12.6

What to know about lactic acid in sepsis?

We are going to learn about lactic acid in sepsis and other pathologies. The objective is to maintain the respect of patients with an elevated lactate, but to understand where it comes from. Also, I would like to decouple the thought process where elevated lactate levels need IV fluids.

When does lactate clearance go up or down in sepsis?

A paper published my Nguyen et al that is NOT FREE looked at early lactate clearance in severe sepsis and septic shock. They found that the higher the amount of “clearance”, the better the patients did in the first 6 hours. So if the lactate goes does, it’s much better than it going up or staying the same.

Why are serum lactate levels elevated in septic shock?

Septic shock status with liver dysfunction and acute kidney injury elevate lactate levels because of decreased lactate clearance. Lactate clearance at a discrete time point is an important prognostic factor compared to initial serum lactate level in severe sepsis (7).