Delayed lactate clearance in patients surviving circulatory shock
Falk, J.L.; Rackow, E.C.; Leavy, J.; Astiz, M.E.; Weil, M.H.
Acute Care 11(3-4): 212-215
1985
ISSN/ISBN: 0254-0819 PMID: 3843372 Document Number: 3257
This study identifies delayed lactate clearance following fluid resuscitation of patients surviving circulatory shock. Gradual reduction in blood lactate has also been observed by Vincent et al. in patients resuscitated from hypovolemic shock, Duff et al. in patients resuscitated from septic shock, Jahrmarker et al. in patients resuscitated from cardiogenic shock, and Schuster et al. in patients resuscitated from shock following drug overdose. The delayed clearance of lactate in patients resuscitated from circulatory shock is in marked contradistinction to the rapid clearance of lactate in patients with lactic acidosis resulting from seizure, exercise or cardiopulmonary resuscitation. Orringer et al. studied venous lactate in patients immediately following grand mal seizure. There was a 50% decrease in blood lactate 60 min following the cessation of seizure activity. Leavy et al. assessed the time course of lactic acidosis in patients following resuscitation from cardiac arrest. Among resuscitated survivors, arterial lactate concentration cleared rapidly, reaching half the peak value 1.5 h after cardiac arrest. Leavy et al. also noted progressive increases in arterial lactate during unsuccessful cardiopulmonary resuscitation. Similar data has been reported by Rackwitz et al.. Following strenuous exercise in healthy volunteers, lactate is cleared very rapidly. Belcastro and Bonen observed a 3% per min decrease in lactate concentration after exercise. In contrast to patients in whom lactic acidosis follows convulsive seizure, cardiac arrest or exercise, lactate clears slowly in patients with circulatory shock. We conclude that delayed lactate clearance in patients following resuscitation from circulatory shock can be anticipated.
Document emailed within 1 workday
