Article PDF :

Veiw Full Text PDF

Article type :

Original Article

Author :

Sowmya Madihalli Janardhan Iyengar, Nadia Rose*, B Sarath Chandra

Volume :

12

Issue :

2

Abstract :

Background and Aims: Sepsis is a life-threatening condition resulting from infection, with a mortality rate of 10% and high morbidity. Serum lactate levels are commonly used for diagnosing septic shock and guiding fluid resuscitation. However, the value of serum lactate levels beyond the initial 6 hours of resuscitation remains under investigation, as many septic patients continue to die even after the crucial initial phase of treatment. The primary objective of this study was to assess the association between initial arterial lactate levels and 30-day outcomes in sepsis patients. Additionally, we aimed to explore the relationship between arterial lactate clearance and the initial lactate levels with the 30-day outcome in these patients. Materials and Methods: Patients aged ?18 years with sepsis diagnosed and treated according to the Sepsis Survival Campaign 2021 guidelines. Arterial lactate levels were measured at the time of admission (H0), 6 hours (H6), and 24 hours (H24) using ABG analysis. Lactate clearance was calculated at H6 and H24. Clinical data, treatment details, and 30-day mortality were recorded, with follow-up via phone for discharged patients. Results: Lactate levels at 0, 6, and 24 hours, as well as lactate clearance at 6 and 24 hours, showed significant differences between survivors and non-survivors. Lactate clearance at 6 hours was notably higher in survivors (46.15%) compared to non-survivors (28.81%), with a similar pattern observed at 24 hours. The Area Under the Curve (AUC) of 0.847 from the ROC curve for lactate levels at 6 hours was superior to lactate values measured at 0 and 24 hours, indicating a better prognostic value at this time point. Conclusion: Arterial lactate serves as a strong predictor of mortality in sepsis patients, with elevated lactate levels being associated with a higher risk of death. The lactate value at 6 hours, exhibiting an AUC of 0.847, provides superior prognostic accuracy when compared to measurements taken at 0 and 24 hours.