Prognostic value of lactate levels and lactate clearance in sepsis and septic shock with initial hyperlactatemia: A retrospective cohort study according to the Sepsis-3 definitions

摘要

Lactateis known to play a major rolein energy production and cellular metabolism. [1] Lacticacidosiscan occur in variousconditions such as sepsis, liver diseases, trauma, shock, vigorousexercises, drug intoxication,and cancer. [2] The 2016 Surviving Sepsis Campaign guidelines suggest guiding resuscitation to normalizelactatelevels in patients with sepsis-associated hyperlactatemiaasa marker oftissue hypoperfusion (hypoxia or oxygen debt). [3,4] Previous studies showed that other nonhypoxiccausescan contributeto theelevation oflactatelevels. [5–10] Besides tissue hypoxia, mitochondrial defect in oxygen utilization, impaired function of pyruvate dehydrogenase, mismatch between oxygen delivery and oxygen consumption,and accelerated aerobic glycolysis driven by sepsis-associated inflammation have been proposed as potentialcauses oflactate elevation.