Blood Lactic Acid Levels Research Articles

Predictive value of IL-8 for mortality risk in elderly sepsis patients of emergency department

BackgroundSepsis significantly impacts morbidity and mortality, particularly among older adults. Despite extensive research, early recognition and prognosis prediction of sepsis remain challenging. IL-8, a chemokine produced by inflammatory cells like monocytes and endothelial cells, has shown potential in predicting mortality in sepsis patients, though its role in elderly sepsis remains unexplored. ObjectivesThe present study aimed to explore the predictive ability of interleukin-8 (IL-8) for mortality risk in elderly septic patients. Methods220 elderly sepsis patients were included in the present study. Serum samples were obtained within 1 h of admission to assess serum IL-8, white blood cell (WBC), procalcitonin (PCT), C-reactive protein (CRP), and lactic acid (LAC) levels. The Sequential Organ Failure Score (SOFA) and Acute Physiological and Chronic Health Assessment II (APACHE II) were recorded. Logistic regression analysis was employed to identify independent predictors of mortality within 28 days for elderly patients diagnosed with sepsis. Further, the capacity of these factors to predict 28-day mortality within this patient cohort was evaluated. ResultsSOFA score, APACHE II score, LAC, and IL-8 were all significant independent predictors for 28-day mortality in elderly sepsis patients (P < 0.05). The AUC of the ROC curve for IL-8 was calculated to be 0.701, indicating a moderately predictive performance. In comparison, the AUC for LAC was marginally higher at 0.708. Nevertheless, the results of the statistical analysis revealed no significant difference in the predictive value between IL-8 and LAC. Moreover, the present findings indicate that the combined assessment of IL-8 and SOFA score demonstrated superior predictive value for mortality compared to using IL-8 alone. ConclusionsIL-8 LAC, APACHE II, and SOFA can be considered independent predictors factors for mortality of elderly sepsis patients. Utilizing the combination of IL-8 and SOFA demonstrates a heightened predictive capability compared to using any single index alone.

Amyloid A and lactic acid as a predictor in patients with sepsis in patients with liver cirrhosis

BackgroundSepsis is triggered by pathogenic microorganisms, resulting in a systemic inflammatory response. Liver cirrhosis and sepsis create a vicious cycle: cirrhosis weakens immune function, raising infection risk and hindering pathogen clearance. Optimal treatment outcomes depend on understanding liver cirrhosis patients’ sepsis risk factors. Thus, preventing sepsis involves addressing these risk factors. Therefore, early identification and understanding of clinical characteristics in liver cirrhosis patients with sepsis are crucial for selecting appropriate antibiotics. A case-control study using logistic regression was conducted to examine the prognostic value of amyloid A/lactate level monitoring in identifying sepsis risk factors in liver cirrhosis patients.MethodsFrom March 2020 to March 2022, 136 liver cirrhosis patients treated at our hospital were divided into a sepsis group (n = 35) and a non-sepsis group (n = 101) based on sepsis complications. General clinical data were collected. Univariate analysis screened for liver cirrhosis patients’ sepsis risk factors. Multivariate logistic analysis was subsequently employed to evaluate the risk factors. Sepsis patients were followed up for a month. Based on prognosis, patients were categorized into a poor prognosis group (n = 16) and a good prognosis group (n = 19). Serum amyloid A (SAA) and blood lactic acid (BLA) levels were compared between the two groups. The receiver operating characteristic (ROC) curve was used to evaluate the prognostic value of both individual and combined SAA/BLA monitoring.ResultsPatient data, including age, diabetes history, liver cancer, hepatic artery embolization, recent antibiotic use, invasive procedures within two weeks, APACHE II Scoring, ALB and SAA and BLA levels, were compared between the sepsis and non-sepsis groups, showing significant differences (P < 0.05). Logistic regression identified factors such as age ≥ 70, recent antibiotic use, recent invasive procedures, history of liver cancer, hepatic artery embolization history, high APACHE II scores, decreased albumin, and elevated SAA and BLA levels as independent sepsis risk factors in liver cirrhosis patients (P < 0.05). Among the 35 sepsis patients, 16 had a poor prognosis, representing an incidence rate of 45.71%. Serum SAA and BLA levels were significantly higher in the poor prognosis group than in the good prognosis group (P < 0.05). The AUC for serum SAA and BLA was 0.831 (95%CI: 0.738–0.924), 0.720 (95%CI: 0.600–0.840), and 0.909 (95%CI: 0.847–0.972), respectively. The combined diagnostic AUC was significantly higher than that of single factor predictions (P < 0.05). The predictive value ranked as follows: joint detection > SAA > BLA.ConclusionIn treating liver cirrhosis, prioritize patients with advanced age, a history of hepatic artery embolization, recent invasive operations, history of liver cancer, recent antibiotic exposure, high APACHE II scores and low albumin. Closely monitoring serum SAA and BLA levels in these patients can offer valuable insights for early clinical prevention and treatment.

Transcranial magnetic stimulation in the assessment of acupuncture effect on exercise-induced fatigue.

Acupuncture as a traditional Chinese medicine therapy relies on unique theories to alleviate fatigue. The aim of this study is to evaluate the effect of acupuncture on exercise-induced fatigue utilizing transcranial magnetic stimulation (TMS). A total of 20 participants with regular exercise habits were recruited for this study. All participants were randomly assigned to receive either acupuncture or sham acupuncture intervention for exercise-induced fatigue. TMS and a heart rate monitor were used to measure the amplitude and latency of motor evoked potential (MEP) as well as heart rate every 5min over a 30-min period. The blood lactic acid (BLA) levels were measured using Lactate Scout+ at baseline, 0min, and 30min after fatigue. Two-way repeated measures analysis of variance was utilized to compare the differences between the effects of acupuncture method and time. Bonferroni post hoc tests were conducted to compare specific differences. Statistical significance was set at p<.05. Interaction effect was observed between acupuncture method and time effect in terms of amplitude (F(1, 38)=5.40, p<.001, η2=0.12) and latency (F(1, 38)=3.78, p=.008, η2=.09) of MEP. The application of acupuncture can promote the recovery of heart rate especially at 30min (p<.05), but which seem insufficient to generate significant difference in BLA (F(1, 38)=0.067, p=.797, η2=0.002). Acupuncture can promote the increase of MEP amplitude, shorten MEP latency, and restore heart rate. Preliminary findings provide novel insights for individuals with exercise habits to alleviate fatigue and enhance sports performance.

Analysis of the effects of early screening combined with blood lactate on the severity of patients with sepsis

This work aimed to investigate the adoption value of blood lactic acid (BLA) combined with the National Early Warning Score (NEWS) in the early screening of sepsis patients and assessing their severity. The data and materials utilized in this work were obtained from the electronic medical record system of 537 anonymized sepsis patients who received emergency rescue in the emergency rescue area of Liuzhou People's Hospital, Guangxi, from July 1, 2020, to December 26, 2020. Based on the 28-day outcomes of sepsis patients, the medical records were rolled into Group S (407 survival cases) and Group D (130 dead cases). Basic information such as the mode of hospital admission, initial management, use of emergency ventilator within 24 h of admission, NEWS score, arterial oxygen pressure/alveolar oxygen pressure ratio (PaO2/PAO2), alveolar-arterial oxygen difference (A-aDO2), serum creatinine (SCr), blood urea nitrogen (BUN), oxygenation index (OI), Glasgow Coma Scale (GCS), D-dimer, use of vasoactive drugs within 24 h of admission, C-reactive protein (CRP), procalcitonin (PCT), interleukin-6 (IL-6), N-terminal pro-B-type natriuretic peptide (NT-proBNP), quick Sequential Organ Failure Assessment (qSOFA) score, SOFA score, BLA level, NEWS with lactate (NEWS-L) score, SOFA score including lactate level (SOFA-L) score, Intensive Care Unit (ICU) length of stay, total hospital stay, ICU stay/total hospital stay, and septic shock condition were compared between groups. Logistic regression analysis was performed to assess the impact of various predictive factors on prognosis and to plot the receiver operating characteristic (ROC) curve. The results suggested marked differences between Group S and Group D in terms of mean age (t = −5.620; OR = −9.96, 95 % CI: −13.44∼-6.47; P < 0.001). Group S showed drastic differences in terms of mode of hospital admission (χ2 = 9.618, P < 0.01), method of initial management (χ2 = 51.766, P < 0.001), use of emergency ventilator within 24 h of admission (χ2 = 98.564, P < 0.001), incidence of septic shock (χ2 = 77.545, P < 0.001), use of vasoactive drugs within 24 h of admission (χ2 = 102.453, P < 0.001), heart rate (t = −4.063, P < 0.001), respiratory rate (t = −4.758, P < 0.001), oxygenation status (χ2 = 20.547, P < 0.001), NEWS score (t = −6.120, P < 0.001), PaO2/PAO2 ratio (t = 2.625, P < 0.01), A-aDO2 value (Z = −3.581, P < 0.001), OI value (Z = −3.106, P < 0.01), PLT value (Z = −2.305, P < 0.05), SCr value (Z = −3.510, P < 0.001), BUN value (Z = −3.170, P < 0.01), D-dimer (Z = −4.621, P < 0.001), CRP level (Z = −4.057, P < 0.001), PCT value (Z = −2.783, P < 0.01), IL-6 level (Z = −2.904, P < 0.001), length of hospital stay (Z = −4.138, P < 0.001), total hospital stay (Z = −8.488, P < 0.001), CCU/total hospital stay (Z = −9.118, P < 0.001), NEWS score (t = −6.120, P < 0.001), SOFA score (t = −6.961, P < 0.001), SOFA-L score (Z = −4.609, P < 0.001), NEWS-L score (Z = −5.845, P < 0.001), BLA level (Z = −6.557, P < 0.001), and GCS score (Z = 6.909, P < 0.001) when compared to Group D. The use of ventilators, septic shock, PCT, NEWS score, GCS score, SOFA score, SOFA-L score, NEWS-L score, and BLA level were identified as independent risk factors for predicting the prognosis of sepsis patients (P < 0.001). The areas under ROC curve (AUC) of blood lactic acid, PCT, NEWS, NEWS-L, GCS, SOFA, and SOFA-L were 0.695, 0.665, 0.692, 0.698, 0.477, 0.700, and 0.653, respectively. These findings indicate that the combination of BLA with NEWS (NEWS-L) score and SOFA score has certain advantages in assessing the prognosis of sepsis.

The anti-fatigue and sleep-aiding effects vary significantly among different recipes containing Ganoderma lucidum extracts

AimsThis study aims to delve into the anti-fatigue and sleep-aiding effects of various formulations containing Ganoderma lucidum extracts. Materials and methodsPGB [incorporating Ganoderma lucidum extract (GE), broken Ganoderma lucidum spore powder (GB) and Paecilomyces hepiali mycelium (PH)] and GBS [composed of GE, GB, and Ganoderma sinense powder (GS)] were chosen as representative recipes for this study. Mice were treated with these recipes or key components of Ganoderma lucidum for 14 consecutive days. Subsequently, a weight-bearing swimming experiment was conducted to assess the mice's exhaustion time and evaluate the anti-fatigue properties of the recipes. Sleep-aiding effects were analyzed by measuring the sleep latency and duration. Furthermore, levels of blood lactic acid, serum urea nitrogen, hepatic glycogen, muscle glycogen, and malondialdehyde (MDA) were measured in the livers and muscles. Key findingsThe anti-fatigue abilities of the tested mice were significantly improved after treatment with PGB and their sleep quality improved as well with GBS treatment. PGB treatment for 14 days could significantly prolong the exhaustion time in weight-bearing swimming (from 10.1 ± 0.5 min to 15.2 ± 1.3 min). Meanwhile, glycogen levels in the livers and muscles were significantly increased, while the levels of serum lactic acid, serum urea nitrogen, and MDA in the livers and muscles were significantly decreased. In contrast, mice treated with GBS for 14 days experienced significant improvements in sleep quality, with shortened sleep latency (from 6.8 ± 0.7 min to 4.2 ± 0.4 min), extended sleep duration (from 88.3 ± 1.4 min to 152.5 ± 9.3 min), and decreased muscle MDA levels. These results indicated that Ganoderma lucidum extracts can be used for anti-fatigue and or aid in sleeping, depending on how they are prepared and administered. SignificanceThis study provides experimental evidence and theoretical basis for the development of Ganoderma lucidum recipes that are specifically designed to help with anti-fatigue and sleep.

Research progress of diagnostic and therapeutic value of carbon dioxide-derived indicators in patients with sepsis

Effectively assessing oxygen delivery and demand is one of the key targets for fluid resuscitation in sepsis. Clinical signs and symptoms, blood lactic acid levels, and mixed venous oxygen saturation (SvO2) or central venous oxygen saturation (ScvO2) all have their limitations. In recent years, these limitations have been overcome through the use of derived indicators from carbon dioxide (CO2) such as mixed veno-arterial carbon dioxide partial pressure difference (Pv-aCO2, PCO2 gap, or ΔPCO2), the ratio of mixed veno-arterial carbon dioxide partial pressure difference to arterial-mixed venous oxygen content difference (Pv-aCO2/Ca-vO2). Pv-aCO2, PCO2 gap or ΔPCO2 is not a purely anaerobic metabolism indicator as it is influenced by oxygen consumption. However, it reliably indicates whether blood flow is sufficient to carry CO2 from peripheral tissues to the lungs for clearance, thus reflecting the adequacy of cardiac output and metabolism. The Pv-aCO2/Ca-vO2 may serve as a marker of hypoxia. SvO2 and ScvO2 represent venous oxygen saturation, reflecting tissue oxygen utilization. When oxygen delivery decreases but tissues still require more oxygen, oxygen extraction rate usually increases to meet tissue demands, resulting in decreased SvO2 and ScvO2. But in some cases, even if the oxygen delivery rate and tissue utilization rate of oxygen are reduced, it may still lead to a decrease in SvO2 and ScvO2. Sepsis is a classic example where tissue oxygen utilization decreases due to factors such as microcirculatory dysfunction, even when oxygen delivery is sufficient, leading to decrease in SvO2 and ScvO2. Additionally, the solubility of CO2 in plasma is approximately 20 times that of oxygen. Therefore, during sepsis or septic shock, derived variables of CO2 may serve as sensitive markers for monitoring tissue perfusion and microcirculatory hemodynamics. Its main advantage over blood lactic acid is its ability to rapidly change and provide real-time monitoring of tissue hypoxia. This review aims to demonstrate the principles of CO2-derived variables in sepsis, assess the available techniques for evaluating CO2-derived variables during the sepsis process, and discuss their clinical relevance.

The impact of blood lactic acid levels on retinopathy of prematurity morbidity

BackgroundRetinopathy of prematurity (ROP) is a common disease in premature infants. In recent years, most researchers have used lactic acid as poor prognosis marker in premature infants. This study aims to explore investigate the impact of blood lactic acid levels on ROP.MethodsA retrospective case-control study was conducted, and infants with severe ROP born with birth weight (BW) ≤ 1500 g and gestational age (GA) ≤ 32 weeks were enrolled from November 2016 to November 2021. Infants without any stage ROP were included as controls and were matched with ROP infants (1:2) by GA and BW. All selected preterm infants were tested for heel terminal trace blood gas analysis within two weeks of life. Changes in blood lactic acid levels in the two groups were compared and analyzed by using multivariate logistic regression analysis. Sensitivity and specificity were analyzed by receiver operating characteristic (ROC) curve.ResultsThere were 79 infants in ROP group, and 158 infants in control group. The levels of blood lactic acid were significantly higher in the ROP group on days 1, 3, 5, and 7 compared with control group (all p < 0.05). The blood lactic acid levels on day 5 was an independent risk factor for ROP (p = 0.017). The area under the curve (AUC), sensitivity and specificity were highest on day 5 (AUC 0.716, sensitivity 77.2% and specificity 62.0%, respectively, p < 0.001), and higher on days 1, 3, and 7.ConclusionA high blood lactic acid level in the first seven days of life may be associated with increases ROP occurrence in very preterm infants, and suggest blood lactic acid level may impact the occurrence of ROP.

Oyster (Ostrea Plicatula Gmelin) Peptides Improve Exercise Endurance Capacity via Activating AMPK and HO-1

Objective Previous studies have shown that oyster peptides (OPs) have antioxidant and anti-fatigue activities. This study aimed to investigate the effects of OPs on swimming endurance in mice and the underlying mechanisms. Methods The mice were subjected to gavage with OPs and subjected to exercise training. After 14 days, various biochemical indicators in the blood and gastrocnemius muscle of mice were assessed, and real-time PCR was utilized to detect the level of signal pathway regulation by OPs in the gastrocnemius muscle. Molecular docking technology was employed to observe the potential active components in OPs that regulate signal pathways. Results In this study, OPs supplementation combined with and without exercise significantly extended swimming time compared to the sedentary group. OPs supplementation with exercise also increased glycogen levels and decreased blood urea nitrogen, lactate dehydrogenase, and lactic acid levels. Additionally, mice in the exercise with OPs group exhibited higher activities of antioxidant enzymes. OPs can upregulate metabolic regulatory factors such as AMP-activated protein kinase, peroxisome proliferator-activated receptor gamma coactivator-1 alpha, peroxisome proliferator-activated receptor delta, and glucose transporter 4, thereby increasing energy supply during exercise. Additionally, OPs enhances the expression of heme oxygenase 1 and superoxide dismutase 2, thereby reducing oxidative stress during physical activity. Molecular docking analyses revealed that peptides found in OPs formed hydrogen bonds with AMPK and HO-1, indicating that they can exert bioactivity by activating target proteins such as AMPK and HO-1. Conclusions OPs supplementation improved energy reserves, modulated energy metabolism pathways, and coordinated antioxidative stress responses, ultimately enhancing swimming endurance. These findings suggest that OPs have the potential to improve exercise levels by promoting metabolism and improving energy utilization efficiency.

Can Manual Lymph Drainage Be Considered as a Passive Recovery Strategy?

The aim of this study was to investigate the acute effects of Swedish massage and manual lymph drainage (MLD) on performance parameters related to jumping, walking, and blood lactic acid levels after Nordic hamstring exercises. This study was designed as a controlled crossover study. The study included 16 young trained men. Participants' lactic acid levels, gait-related parameters, and jumping performance were assessed. Assessments were performed at baseline, after Nordic hamstring exercises, and after 3 different passive recovery strategies: resting, Swedish massage, and MLD for 3weeks. As a result of the study, it was observed that lactic acid levels after the MLD and massage intervention were significantly lower in both MLD and massage conditions compared with the control condition (P < .05). There was no within- and between-conditions difference in jumping parameters after the MLD and massage interventions (P > .05). Walking speed in the MLD condition was statistically higher following the intervention compared with both before and after exercise (P < .05). Step time in the massage condition was statistically lower after the intervention compared with after Nordic hamstring exercise (P < .05). Although MLD and massage interventions have positive effects on lactic acid levels and walking and jumping parameters, they are not superior to each other. MLD can be used as a passive recovery technique after exercise.

Blood Lactic Acid Level and Heart Rate Monitoring during the Recovery Phase after the Maximum Anaerobic Exercise with Wearing KF-94 Face Masks in Soft Tennis Athletes

Blood Lactic Acid Level and Heart Rate Monitoring during the Recovery Phase after the Maximum Anaerobic Exercise with Wearing KF-94 Face Masks in Soft Tennis Athletes

Clinical analysis of 86 cases of acute fatty liver of pregnancy

Objective: To investigate the clinical characteristics and maternal and fetal prognosis of pregnant women with acute fatty liver of pregnancy (AFLP). Methods: The clinical data of 86 AFLP pregnant women admitted to the Third Affiliated Hospital of Guangzhou Medical University from September 2017 to August 2022 were collected, and their general data, clinical characteristics, laboratory tests and maternal and fetal outcomes were retrospectively analyzed. Results: (1) General information: the age of the 86 pregnant women with AFLP was (30.8±5.4) years, and the body mass index was (21.0±2.5) kg/m2. There were 50 primiparas (58.1%, 50/86) and 36 multiparas (41.9%, 36/86). There were 64 singleton pregnancies (74.4%, 64/86) and 22 twin pregnancies (25.6%, 22/86). (2) Clinical characteristics: the main complaints of AFLP pregnant women were gastrointestinal symptoms, including epigastric pain (68.6%, 59/86), nausea (47.7%, 41/86), anorexia (46.5%, 40/86), vomiting (39.5%, 34/86). The main non-gastrointestinal symptoms were jaundice of skin and/or scleral (54.7%, 47/86), edema (38.4%, 33/86), fatigue (19.8%, 17/86), bleeding tendency (16.3%, 14/86), polydipsia or polyuria (14.0%, 12/86), skin itching (8.1%, 7/86), and 17.4% (15/86) AFLP pregnant women had no obvious symptoms. (3) Laboratory tests: the incidence of liver and kidney dysfunction and abnormal coagulation function in AFLP pregnant women was high, and the levels of blood ammonia, lactate dehydrogenase and lactic acid were increased, and the levels of hemoglobin, platelet and albumin decreased. However, only 24 cases (27.9%, 24/86) of AFLP pregnant women showed fatty liver by imageology examination. (4) Pregnancy outcomes: ① AFLP pregnant women had a high incidence of pregnancy complications, mainly including renal insufficiency (95.3%, 82/86), preterm birth (46.5%, 40/86), hypertensive disorders in pregnancy (30.2%, 26/86), gestational diabetes mellitus (36.0%, 31/86), fetal distress (24.4%, 21/86), pulmonary infection (23.3%, 20/86), disseminated intravascular coagulation (16.3%, 14/86), multiple organ dysfunction syndrome (16.3%, 14/86), hepatic encephalopathy (9.3%, 8/86), and intrauterine fetal death (2.3%, 2/86). ② Treatment and outcome of AFLP pregnant women: the intensive care unit transfer rate of AFLP pregnant women was 66.3% (57/86). 82 cases were improved and discharged after treatment, 2 cases were transferred to other hospitals for follow-up treatment, and 2 cases (2.3%, 2/86) died. ③ Neonatal outcomes: except for 2 cases of intrauterine death, a total of 106 neonates were delivered, including 39 cases (36.8%, 39/106) of neonatal asphyxia, 63 cases (59.4%, 63/106) of neonatal intensive care unit admission, and 3 cases (2.8%, 3/106) of neonatal death. Conclusions: AFLP is a severe obstetric complication, which is harmful to mother and fetus. In the process of clinical diagnosis and treatment, attention should be paid to the clinical manifestations and laboratory tests of pregnant women, early diagnosis and active treatment, so as to improve maternal and fetal outcomes.

Metformin-Associated Lactic Acidosis Precipitated by an Acute Obstructing Ureteral Stone in a Patient with a Single Functioning Kidney

A 35-year-old male with type-2 diabetes mellitus and a history of insulin and metformin (2,000 mg/day) use presented to the emergency department (ED) with generalized weakness. Abdominal computed tomography (CT) performed 3 months prior to presentation showed a severely atrophic right kidney and a few tiny stones in the left kidney, with a serum level of creatinine of 1.14 mg/dL. At the ED, the patient’s blood pressure was 153/89 mmHg. Workup revealed acute kidney injury (creatinine, 11.97 mg/dL), high-anion-gap metabolic acidosis (pH, 6.93), and a blood lactic acid level &gt; 15 mmol/L. Based on the medication history, the patient was diagnosed with metformin-associated lactic acidosis. CT showed a left distal ureteral stone, measuring 6 mm in size, which resulted in hydroureteronephrosis. The patient was initially treated with continuous renal replacement therapy. Subsequently, left percutaneous nephrostomy was performed, which led to the return of the creatinine level to baseline, with complete resolution of lactic acidosis.

Antifatigue effects and antioxidant activity in polysaccharide fractions from Chinese yam bulbils.

Polysaccharides are the principal component in Chinese yam (Dioscorea opposita Thunb.) bulbils. The properties and antifatigue of polysaccharides from yam bulbils (PYB) were identified and compared. Their molecular weights (PYB-1 and PYB-2) were approximately 145 and 11 kDa, respectively, with active β-configurations. Meanwhile, the antifatigue activities of PYBs were tested in mice via exhaustive swimming tests (EST). The EST results indicated that PYB-1 and PYB-2 significantly prolonged swimming time in mice (p < .05). Associated with this increase was a rise in hepatic glycogen content and antioxidant enzyme (superoxide dismutase (SOD), glutathione peroxidase (GSH-Px)) activity, along with a decline in blood urea nitrogen, lactic acid, and malondialdehyde levels. The results showed that molecular weight might contribute to the antifatigue effects of PYBs. Additionally, antioxidant tests showed that PYB-1 had stronger free-radical scavenging activity than PYB-2. Taken together, the findings indicated that PYBs exhibited effective antifatigue and antioxidant activities providing additional evidence supporting the use of PYBs as functional food ingredients for relieving fatigue.

Comparing Efficacy of Rhodiola Rosea, Red Goji Berry, and Siraitia Grosvenorii in Physical Recovery After Aerobic Exercise

This manuscript compares the effects of Rhodiola rosea, red goji berry, and Siraitia grosvenorii on the recovery of physical strength in athletes after aerobic exercise. Subjects were compared for the effects of different treatments on changes in physiological (heart rate, rating of perceived exertion, and vertical jump-and-reach performance) and biochemical (blood lactic acid, creatine kinase, and blood urea nitrogen) markers after four weeks of aerobic exercise. After four weeks of aerobic exercise, the heart rate of all groups of athletes increased rapidly, the level of fatigue deepened, the vertical jump-andreach performance decreased, and the levels of blood lactic acid, creatine kinase, and blood urea nitrogen all increased to varying degrees. At the 12th minute after exercise, the heart rate of the Rhodiola rosea group, the red goji berry group, and the Siraitia grosvenorii group recovered faster, the RPE value was lower, and the vertical jump-and-reach performance was better compared with the control, P &lt; 0.05; moreover, the levels of all three biochemical markers were all significantly lower than those of the control group. In conclusion, the intake of these nutrients can promote the recovery of physical strength in athletes, accelerate the clearance of blood lactate, and inhibit the generation of creatine kinase and blood urea nitrogen. Therefore, they can be used as nutritional support for athletes during aerobic exercise.

FRI095 Pseudo Anion Gap Metabolic Acidosis Secondary To Severe Hypertriglyceridemia

Abstract Disclosure: G.C. Connery: None. S. Ward: None. K.E. Izuora: None. A. Champion: None. Background/Objective: Severe hypertriglyceridemia can falsely alter multiple lab parameters due to the high lipid fraction of the blood sample. We present a patient who initially presented with severe metabolic acidosis but proved to have normal pH and bicarbonate after correction for hypertriglyceridemia. Case Report: A 34-year-old female with past medical history of recurrent acute on chronic pancreatitis secondary to hypertriglyceridemia, type 2 diabetes, obesity, and hypertension presented to the emergency department with epigastric pain. The patient was initially diagnosed with acute pancreatitis, diabetic ketoacidosis (DKA), and hyponatremia. Initial labs showed sodium 116 mmol/L, glucose 617 mg/dL, bicarbonate &amp;lt; 5 mmol/L, blood ketones 0.8 mmol/L, lactic acid 2.57 mmol/L, and creatinine 0.95 mg/dL. A venous blood gas (VBG) revealed pH 7.42, pCO2 36 mmHg, pO2 62 mmHg, and bicarbonate 24 mmol/L. Her lipid panel revealed triglyceride levels &amp;gt; 4000 mg/dL. The discrepancy in bicarbonate levels between the blood chemistries and VBG were attributed to a pseudo-anion gap metabolic acidosis secondary to her hypertriglyceridemia. After treatment with insulin infusion, hypertriglyceridemia resolved and her bicarbonate levels on renal function panel normalized. Discussion: The high lipid fraction of blood plasma in patients with severely high triglyceride levels can confound other laboratory parameters. Pseudo hyponatremia secondary to elevated triglycerides is one example of a commonly known lab abnormality. In our patient, her initial bicarbonate levels on renal function panel led to concern for severe metabolic acidosis that was not consistent with her mild blood ketones and lactic acid levels. Further investigation with VBG revealed normal pH and bicarbonate levels. Conclusion: Severe hypertriglyceridemia may significantly alter bicarbonate measurement on blood chemistries. Further investigations with blood gasses should be pursued to confirm these abnormalities when suspected. Presentation: Friday, June 16, 2023

Short-term survival survey and risk factors analysis of death in sepsis patients in intensive care unit

To analyze the 28-day survival status and influencing factors of adult patients with sepsis, providing reference for early diagnosis of sepsis prognosis and reducing sepsis mortality. A retrospective cohort study was conducted. A total of 160 adult patients with sepsis in the department of intensive care unit of the 940th Hospital of Joint Logistic Support Force of PLA from January 2021 to December 2022 were enrolled. The general information, laboratory examination results within 24 hours after admission, clinical treatment measures, and prognosis of patients were collected. Univariate analysis and binary multivariate Logistic regression were performed to screen the risk factors that might affect the short-term prognosis of patients with sepsis. Receiver operator characteristic curve (ROC curve) was plotted to analyze the predictive value of various risk factors on the short-term death risk of sepsis patients. A total of 160 patients with sepsis were enrolled, of whom 91 survived in 28 days, and 69 died with a mortality of 43.12%. Compared with the survival group, the patients in the death group were older, more severe, had higher blood lactic acid (Lac) level, and had more complications such as hypertension and multiple organ dysfunction syndrome (MODS). A total of 22 related factors were statistically significant: age, acute physiology and chronic health evaluation II (APACHE II) score, sequential organ failure assessment (SOFA) score, length of hospital stay, Lac, interleukin-6 (IL-6), fibrinogen (FIB), international normalized ratio (INR), ratio of prothrombin time (PT) to healthy people, prothrombin activity (PTA), PT, thrombin time (TT), oxygenation index (PaO2/FiO2), aspartate aminotransferase (AST), ratio of AST to alanine amninotransferase (ALT), serum creatinine (SCr), blood urea nitrogen (BUN), site of infection, history of hypertension, concurrent MODS, implementation of continuous renal replacement therapy (CRRT), and treatment with vasoactive drugs. Combined with the results of the univariate analysis, variables that might affect the short-term prognosis of septic patients were included in the multivariate Logistic regression analysis. The results showed that APACHE II score ≥ 20 [odds ratio (OR) = 1.106, 95% confidence interval (95%CI) was 1.003-1.219], Lac ≥ 5 mmol/L (OR = 1.430, 95%CI was 1.041-1.964), combined with hypertension (OR = 13.879, 95%CI was 1.082-178.016), concurrent MODS (OR = 98.139, 95%CI was 18.252-527.672) was an independent risk factor for 28-day death in adult septic patients (all P < 0.05). ROC curve analysis showed that the combination of the four indicators including APACHE II score, Lac, combined with hypertension, concurrent MODS, had predictive value for short-term outcomes in patients with sepsis. The area under the ROC curve (AUC) was higher than that of the 4 indicators alone [AUC (95%CI): 0.952 (0.918-0.986) vs. 0.745 (0.670-0.820), 0.816 (0.748-0.883), 0.608 (0.518-0.699), 0.868 (0.810-0.927)], the sensitivity was 94.2%, and the specificity was 90.1%. APACHE II score within 24 hours, Lac, combined with hypertension, and concurrent MODS are independent risk factors for short-term mortality in adult septic patients in ICU. The combination of these indicators can make meaningful early clinical judgments on the short-term prognosis of septic patients, thereby reducing the mortality.

Continuous renal replacement therapy with oXiris® in patients with hematologically malignant septic shock: A retrospective study.

The mortality rate from septic shock in patients with hematological malignancies (HMs) remains significantly higher than that in patients without HMs. A longer resuscitation time would definitely be harmful because of the irreversibly immunocompromised status of the patients. Shortening the resuscitation time through continuous renal replacement therapy (CRRT) with oXiris® would be an attractive strategy in managing such patients. To explore the effects of CRRT and oXiris® in shortening the resuscitation time and modifying the host response by reducing inflammation mediator levels. Forty-five patients with HM were diagnosed with septic shock and underwent CRRT between 2018 and 2022. Patients were divided into two groups based on the hemofilter used for CRRT (oXiris® group, n = 26; M150 group, n = 19). We compared the number of days of negative and total fluid balance after 7 d of CRRT between the groups. The heart rate, norepinephrine dose, Sequential Organ Failure Assessment (SOFA) score, and blood lactic acid levels at different time points in the two groups were also compared. Blood levels of inflammatory mediators in the 26 patients in the oXiris® group were measured to further infer the possible mechanism. The average total fluid balance after 7 d of CRRT in the oXiris® group was significantly lower than that of patients in the M150 hemofilter group. The SOFA scores of patients after CRRT with oXiris® therapy were significantly lower than those before treatment on day 1 (d1), d3 and d7 after CRRT; these parameters were also significantly lower than those of the control group on d7. The lac level after oXiris® therapy was significantly lower than that before treatment on d3 and d7 after CRRT. There were no significant differences in the above parameters between the two groups at the other time points. In the oXiris® group, procalcitonin levels decreased on d7, whereas interleukin-6 and tumor necrosis factor levels decreased significantly on d3 and d7 after treatment. CRRT with oXiris® hemofilter may improve hemodynamics by reducing inflammatory mediators and playing a role in shortening the resuscitation period and decreasing total fluid balance in the resuscitation phases.

Mean Platelet Volume (MPV) and Plasma Lactate Level in the Diagnosis and Prognosis of Neonatal Bacteremia

Abstract Background Neonatal sepsis is a life-threatening clinical condition. It is associated with high morbidity and mortality if not treated properly. Blood culture remains the gold standard method diagnosis of sepsis, but it takes at least 24 hours for presumptive diagnosis. Owing to the fact that neonates are vulnerable and can deteriorate easily, rapid diagnosis and management is a must. Aim of the Work Determination of the role of mean platelet volume (MPV) and Blood Lactic acid (BLA) level in the diagnosis and prognosis of neonatal bacteremia. Materials and Methods Study included 108 clinically septic neonates aged 0-28 days, admitted to NICU in Ain Shams University Hospitals. All neonates were subjected to blood culture as gold standard method, complete blood picture (for MPV evaluation), CRP, and BLA, then they were equally divided into two groups bacteremic group, and non-bacteremic group. Results The current study showed that there was a significant difference between bacteremic and nonbacteremic group as regards MPV, CRP, and BLA with higher mean and median values among bacteremic group with P value 0.001, 0.003, and 0.021 respectively. High BLA level was found to be highly significant in non-survived neonates when compared to the survived ones with P value 0.001. Conclusion MPV and BLA tests are simple, rapid, and inexpensive methods to diagnose neonatal bacteremia. The available evidence confirms significantly higher MPV, and BLA in neonates with bacteremia compared to neonates with non-bacteremia causes of sepsis. Therefore, in clinical practice, MPV and BLA could be used as indicators for the early diagnosis of sepsis, while blood lactic acid could be used additionally as a predictor of mortality.

Effect of vitamin energy drinks on relieving exercise-induced fatigue in muscle group by ultrasonic bioimaging data analysis.

This work was aimed to analyze the effect of vitamin energy drink on muscle fatigue by surface electromyography (SEMG) and ultrasonic bioimaging (USBI). 20 healthy men were selected to do increasing load fatigue test. Surface electromyographic signals and ultrasonic biological images were collected based on wavelet threshold function with improved thresholds. Time domain and frequency domain characteristic integrated electromyography (IEMG), root mean square amplitude (RMS), average power frequency (MPF), and surface and deep muscle morphological changes were analyzed. Hemoglobin concentration (HB), red blood cell number (RBC), mean volume of red blood cell (MCV), blood lactic acid (BLA), malondialdehyde (MDA), and phosphocreatine kinase (CK) were measured. 1) the Accuracy (94.10%), Sensitivity (94.43%), Specificity (93.75%), and Precision (94.07%) of the long and short-term memory (LSTM) specificity for muscle fatigue recognition were higher than those of other models. 2) Compared with the control group, the levels of BLA, MDA, and CK in the experimental group were decreased and HB levels were increased after exercise (P < 0.05). 3) IEMG and RMS of the experimental group were higher than those of the control group, and increased with time (P < 0.05). 4) The mean amplitude of the response signal decreased with time. Compared with the control group, the surface muscle thickness, deep muscle thickness, total muscle thickness, contrast, and homogeneity (HOM) decreased in the experimental group; while the angular second moment (ASM) and contrast increased, showing great differences (P < 0.05). Surface electromyographic signal and ultrasonic biological image can be used as auxiliary monitoring techniques for muscle fatigue during exercise. Drinking vitamin energy drinks before exercise can relieve physical fatigue to a certain extent and promote the maintenance of muscle microstructure.

The Efficient Synthesis and Anti-Fatigue Activity Evaluation of Macamides: The Unique Bioactive Compounds in Maca.

Macamides are a class of amide alkaloids that are only found in maca and are widely considered to be its bioactive marker compounds. More than thirty macamide monomers have been identified in recent years; however, it is difficult to obtain a single macamide monomer from the maca plant because of their similar structures and characteristics. We used the carbodiimide condensation method (CCM) to efficiently synthesize five typical macamides, including N-benzyl-hexadecanamide (NBH), N-benzyl-9Z,12Z,15Z-octadecenamide, N-(3-methoxybenzyl)-9Z,12Z-octadecenamide, N-benzyl-9Z,12Z-octadecenamide, and N-(3-methoxybenzyl)-9Z,12Z,15Z-octadecadienamide. All the synthesized macamides were purified by a one-step HPLC with a purity of more than 95%. NBH is the most abundant macamide monomer in natural maca, and it was selected to evaluate the anti-fatigue effects of macamides. The results indicated that NBH could enhance the endurance capacity of mice by increasing liver glycogen levels and decreasing blood urea nitrogen, lactate dehydrogenase, blood ammonia, and blood lactic acid levels. Macamides might be the active substances that give maca its anti-fatigue active function.