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Laktatazidose – Update 2018

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Laktatazidose – Update 2018. / Kluge, Stefan; de Heer, Geraldine; Jarczak, Dominik; Nierhaus, Axel; Fuhrmann, Valentin.

In: DEUT MED WOCHENSCHR, Vol. 143, No. 15, 08.2018, p. 1082-1085.

Research output: SCORING: Contribution to journal › SCORING: Review article › Research

Harvard

Kluge, S, de Heer, G, Jarczak, D, Nierhaus, A & Fuhrmann, V 2018, 'Laktatazidose – Update 2018', DEUT MED WOCHENSCHR, vol. 143, no. 15, pp. 1082-1085. https://doi.org/10.1055/a-0585-7986

APA

Kluge, S., de Heer, G., Jarczak, D., Nierhaus, A., & Fuhrmann, V. (2018). Laktatazidose – Update 2018. DEUT MED WOCHENSCHR, 143(15), 1082-1085. https://doi.org/10.1055/a-0585-7986

Vancouver

Kluge S, de Heer G, Jarczak D, Nierhaus A, Fuhrmann V. Laktatazidose – Update 2018. DEUT MED WOCHENSCHR. 2018 Aug;143(15):1082-1085. https://doi.org/10.1055/a-0585-7986

Bibtex

@article{b2cb72da0bdb42888e1e5330846833df,
title = "Laktatazidose – Update 2018",
abstract = "Severe hyperlactaemia in intensive care patients is most often due to underlying sepsis or septic, cardiogenic or haemorrhagic shock. Hyperlactaemia is an independent predictor of death in various groups of critically ill patients. With serum lactate values > 10 mmol/l 80 % of the patients die in intensive care, and if the severe lactic acidosis persists for 48 hours, all patients die. Increased lactate levels require immediate diagnostic work-up and classification. The new sepsis definition requires a serum lactate > 2 mmol/l for septic shock with adequate volume substitution and vasopressor administration in order to achieve a mean arterial pressure in persistent hypotension ≥ 65 mmHg. The 1-hour bundle of the Surviving Sepsis Campaign published in 2018 recommends as a first measure the determination of the lactate serum concentrations, and increased values should be closely monitored. In addition, blood culture sampling, broad-spectrum antibiotics, fluid resuscitation and vasopressor administration are recommended within the first hour. Large amounts of crystalloids should be given for increased lactate levels (≥ 4 mmol/l) and refractory hypotension, the administration of fluids can be adjusted according to lactate clearance. Lactate metabolism is prolonged in patients with liver function impairment. Lactate levels on admission to intensive care are significantly associated with the number of failing organs and mortality in patients with cirrhosis. 12-hour lactate clearance has a strong predictive prognosis for survival in patients with baseline lactate levels above 5 mmol/l, the latter remains an independent predictor for the severity of the underlying disease even after correction. The greater the decrease in lactate during the initial therapy, the better the outcome.",
keywords = "English Abstract, Journal Article, Acidosis, Lactic/diagnosis, Critical Care, Humans, Lactic Acid/blood, Liver Diseases/complications, Metabolic Clearance Rate/physiology, Prognosis, Risk Factors, Sepsis/complications, Shock, Septic/complications, Survival Rate",
author = "Stefan Kluge and {de Heer}, Geraldine and Dominik Jarczak and Axel Nierhaus and Valentin Fuhrmann",
note = "{\textcopyright} Georg Thieme Verlag KG Stuttgart · New York.",
year = "2018",
month = aug,
doi = "10.1055/a-0585-7986",
language = "Deutsch",
volume = "143",
pages = "1082--1085",
journal = "DEUT MED WOCHENSCHR",
issn = "0012-0472",
publisher = "Georg Thieme Verlag KG",
number = "15",

}

RIS

TY - JOUR

T1 - Laktatazidose – Update 2018

AU - Kluge, Stefan

AU - de Heer, Geraldine

AU - Jarczak, Dominik

AU - Nierhaus, Axel

AU - Fuhrmann, Valentin

N1 - © Georg Thieme Verlag KG Stuttgart · New York.

PY - 2018/8

Y1 - 2018/8

N2 - Severe hyperlactaemia in intensive care patients is most often due to underlying sepsis or septic, cardiogenic or haemorrhagic shock. Hyperlactaemia is an independent predictor of death in various groups of critically ill patients. With serum lactate values > 10 mmol/l 80 % of the patients die in intensive care, and if the severe lactic acidosis persists for 48 hours, all patients die. Increased lactate levels require immediate diagnostic work-up and classification. The new sepsis definition requires a serum lactate > 2 mmol/l for septic shock with adequate volume substitution and vasopressor administration in order to achieve a mean arterial pressure in persistent hypotension ≥ 65 mmHg. The 1-hour bundle of the Surviving Sepsis Campaign published in 2018 recommends as a first measure the determination of the lactate serum concentrations, and increased values should be closely monitored. In addition, blood culture sampling, broad-spectrum antibiotics, fluid resuscitation and vasopressor administration are recommended within the first hour. Large amounts of crystalloids should be given for increased lactate levels (≥ 4 mmol/l) and refractory hypotension, the administration of fluids can be adjusted according to lactate clearance. Lactate metabolism is prolonged in patients with liver function impairment. Lactate levels on admission to intensive care are significantly associated with the number of failing organs and mortality in patients with cirrhosis. 12-hour lactate clearance has a strong predictive prognosis for survival in patients with baseline lactate levels above 5 mmol/l, the latter remains an independent predictor for the severity of the underlying disease even after correction. The greater the decrease in lactate during the initial therapy, the better the outcome.

AB - Severe hyperlactaemia in intensive care patients is most often due to underlying sepsis or septic, cardiogenic or haemorrhagic shock. Hyperlactaemia is an independent predictor of death in various groups of critically ill patients. With serum lactate values > 10 mmol/l 80 % of the patients die in intensive care, and if the severe lactic acidosis persists for 48 hours, all patients die. Increased lactate levels require immediate diagnostic work-up and classification. The new sepsis definition requires a serum lactate > 2 mmol/l for septic shock with adequate volume substitution and vasopressor administration in order to achieve a mean arterial pressure in persistent hypotension ≥ 65 mmHg. The 1-hour bundle of the Surviving Sepsis Campaign published in 2018 recommends as a first measure the determination of the lactate serum concentrations, and increased values should be closely monitored. In addition, blood culture sampling, broad-spectrum antibiotics, fluid resuscitation and vasopressor administration are recommended within the first hour. Large amounts of crystalloids should be given for increased lactate levels (≥ 4 mmol/l) and refractory hypotension, the administration of fluids can be adjusted according to lactate clearance. Lactate metabolism is prolonged in patients with liver function impairment. Lactate levels on admission to intensive care are significantly associated with the number of failing organs and mortality in patients with cirrhosis. 12-hour lactate clearance has a strong predictive prognosis for survival in patients with baseline lactate levels above 5 mmol/l, the latter remains an independent predictor for the severity of the underlying disease even after correction. The greater the decrease in lactate during the initial therapy, the better the outcome.

KW - English Abstract

KW - Journal Article

KW - Acidosis, Lactic/diagnosis

KW - Critical Care

KW - Humans

KW - Lactic Acid/blood

KW - Liver Diseases/complications

KW - Metabolic Clearance Rate/physiology

KW - Prognosis

KW - Risk Factors

KW - Sepsis/complications

KW - Shock, Septic/complications

KW - Survival Rate

U2 - 10.1055/a-0585-7986

DO - 10.1055/a-0585-7986

M3 - SCORING: Review

C2 - 30060277

VL - 143

SP - 1082

EP - 1085

JO - DEUT MED WOCHENSCHR

JF - DEUT MED WOCHENSCHR

SN - 0012-0472

IS - 15

ER -