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Early Lactate-Guided Resuscitation of Elderly Septic Patients
- Source :
- Journal of Intensive Care Medicine. 37:686-692
- Publication Year :
- 2021
- Publisher :
- SAGE Publications, 2021.
-
Abstract
- Background: Early lactate-guided resuscitation was endorsed in the guidelines of the Surviving Sepsis Campaign as a key strategy to decrease the mortality of patients admitted to the ICU department with septic shock. However, its effectiveness in elderly Asian patients is uncertain. Method: We conducted a single-center trial to test the effectiveness of the early lactate-guided resuscitation of older Asian patients at the Second Hospital of Hebei Medical University. Eligible septic shock patients who consented to participation in the study were randomly assigned to receive early lactate-guided treatment or regular treatment as controls. Result: A total of 82 patients met the hyperlactatemia criteria and participated in the trial. Forty-two patients received early lactate-guided treatment (lactate group) and 40 received regular treatment (control group). The lactate group received more fluids at initial 6 hours (3.3 ± 1.4 vs 2.4 ± 1.7 L, P = 0.01), but similar proportions of patients in both groups required the use of vasopressors and vasodilators. Patients in the lactate group showed significantly reduced ICU needs compared to the control group, which were weaned from mechanical ventilation more quickly (median 7, IQR 4 to 14 vs median 9, IQR 4.3 to 17.8, P = 0.02) and transferred out of the ICU earlier (median 4.5, IQR 2.8 to 7.3 vs median 6, IQR 3.2 to 8, P = 0.01). However, the hospital mortality (35.7% vs 42.5%, P = 0.35) and ICU mortality (31.0% vs 37.5%, P = 0.38) for both groups were not reduced. Conclusion: For critically ill patients (elderly Asian patients) admitted to the ICU department with hyperlactatemia, early lactate-guided treatment reduced ICU needs but did not reduce mortality.
- Subjects :
- medicine.medical_specialty
Resuscitation
Surviving Sepsis Campaign
business.industry
030208 emergency & critical care medicine
Critical Care and Intensive Care Medicine
medicine.disease
Shock, Septic
Sepsis
03 medical and health sciences
0302 clinical medicine
Emergency medicine
Fluid Therapy
Humans
Hyperlactatemia
Medicine
Lactic Acid
030212 general & internal medicine
business
Aged
Subjects
Details
- ISSN :
- 15251489 and 08850666
- Volume :
- 37
- Database :
- OpenAIRE
- Journal :
- Journal of Intensive Care Medicine
- Accession number :
- edsair.doi.dedup.....c1d30474fe303cb93a26a0cb5f7de4ca