Sequential blood lactate measurement as death alarm for the patient with sepsis

Abstract

The lactate levels in the blood are raised in septicemia, signifying reduced oxidative phosphorylation, which secondarily causes hypoxic hypoxia and stagnant tissue hypoxia. Hence, a high rise of the lactate level in blood may be a valuable forecaster of mortality of patients suffering from severe infection along with some biochemical and clinical related factors. Therefore, in the current study, we evaluated the relationship between serial blood lactate levels and mortality among patients with life-threatening sepsis infections admitted to the Critical Care Centre. It was a cross-sectional study. In this descriptive study, we have included 50 septicemic patients above the age of 18 years. At admission, 24 hours and 72 hours, we monitored the blood's lactate levels. Grouping of the patients as survivors and non-survivor was done based on their clinical status for four weeks. To test the difference in mean blood lactate levels among survivors and non-survivors, student's t-test was applied. The statistical analysis was made with Microsoft Excel and SPSS version 20. A p-value of less than 0.05 was considered significant. In the current study, 23 were survivors, and 27 were non-survivors after 28 follow-ups. The mean lactate range for the 23 survivors ranged from 0.43 mmol/l to 5.69 mmol/l, whereas for non-survivors, it was 1.64 mmol/l to 6.14 mmol/l. The mean value of lactate for the survivors and non-survivors during admission time, at 24 hours and 72 hours were 0.9545±0.45798 vs 2.5204±1.51498, 1.2461±1.21360 vs 2.5107±1.63678 and 1.5496±1.66788 vs 2.7904±2.00160. The differences between the mean lactate values between survivors and the fatal group at different time intervals were highly significant. The result reveals serial blood lactate levels as a significant predictor of mortality in patients with sepsis.