The Clinical Value Of Serum Lactate Measurement In Patients With Severe Sepsis Or Septic Shock

Objective: To explore the correlationship between serum lactate level and Acute Physiology and Chronic Health Evaluationâ…¡( APACHEâ…¡) score,arterial partial pressure of oxygen(PaO2),and prognosis in patients with severe sepsis or septic shock. Whether or not lactate can be used as a parameter to judge prognosis and to guide treatment.Methods: Thirty patients with severe sepsis or septic shock were enrolled in the study. They were divided into two groups by prognosis,survivors and nonsurvivors. Serum lactate was measured at 0 hours,12 hours,24 hours,and 48 hours after the enrollment. We meanwhile measured the arterial blood gas and APACHEâ…¡score. Serum lactate was measured by using Vitros250 apparatus and arterial blood gas was measured by using Rapidlab1245 apparatus. Thirty healthy subjects were enrolled as health groups.Results: Serum lactate levels in all the patients was significantly higher than that in healthy controls at 0 hours,12 hours,24 hours,and 48 hours after the enrollment(P<0.05),and it was significantly higher in nonsurvivors and survivors at each time points(P<0.05). There was significantly a positive correlation between serum lactate level and APACHEâ…¡score in all the subjects(r=0.67,P<0.05),survivors and nonsurvivor(sr=0.75,P<0.05;r=0.85,P< 0.05). There was no correlation between serum lactate and in all the subjects(r=-0.16,P>0.05),survivors and nonsurvivors( r =-0.54,P> 0.05; r=0.03,P> 0.05) .Conclusions: As an important parameter of tissue hypoperfusion and hypoxia,serum lactate reflects the enhanced anaerobic metabolism. Serum lactate is a good parameter to evaluate severe sepsis or septic shock. Monitoring serum lactate level and evaluating APACHEâ…¡are helpful in guiding treatment for patients with severe sepsis or septic shock,and also helpful in judging the severity,development and prognosis of the diseases.