Serum Lactate As A Prognostic Marker In Patients With Sepsis-A Prospective Study

Abstract

Background & Objectives: This was a prospective study to estimate the Serum Lactate levels and as a prognostic marker in patients with Sepsis. To estimate the serum lactate values at the time of admission and the second sample value at 24-48 hrs after admission and to predict the outcome of patients with sepsis based on serum lactate levels and its clearance. Methods: This study consists of 170 selected cases patients admitted with sepsis condition in B.L.D.E.U s Shri. B. M.Patil Medical College, Hospital and Research Centre, Vijayapur from October 2014 to June 2016. Results: In thisstudy the mean serum lactate value of first sample in survivors (146 patients) is 3.8 ± 1.2 and nonsurvivors(24 patients) is 6.2 ±1.9 with p value <0.001 which is significant. The serum lactate value of the second sample in survivors(146) is 2.7 ±1.0 and in nonsurvivors(24) is 6.3±1.8 with p value <0.001 which is significant.The mean value of serum lactate 1st sample collected at the time of admission is 4.1±1.6 and the mean value of serum lactate second sample collected at 24-48 hrs after admission is 3.1±1.6.Highly significant difference is there between serum lactate 1st and 2nd sample with p value <0.001 which is significant.Hence serum lactate is considered as a prognostic marker in patients with sepsis and evaluates the treatment outcome. x Interpretation and Conclusion: Fall in lactate concentration following the initiation of treatment for sepsis is due to an attenuation of the stress response. Lactate levels are one of the most used biomarkers in sepsis. When their level is more than 4 mmol/L patients are at highest risk of mortality and an aggressive resuscitation strategy shall be warranted.This study suggests an important role for serial sampling of the subsequent two lactate values and lactate clearance as a prognostic indicator of sepsis.Patients with initial serum lactate value >4.0 mmol/L were independently associated with mortalityand serum lactate had a positive correlation with outcome of sepsis.Hence serum lactate is considered as a independent and significant prognostic marker in patients with sepsis