Wouter De Corte1, S Vuylsteke2, Jan J De Waele3, Annemieke W Dhondt4, Johan Decruyenaere3, Raymond Vanholder4, Eric A J Hoste5. 1. Department of Intensive Care Medicine, Ghent University Hospital, Ghent, Belgium; Department of Anaesthesia and Intensive Care Medicine, AZ Groeninge Hospital, Kortrijk, Belgium. Electronic address: wouter.decorte@azgroeninge.be. 2. Department of Paediatric Medicine, Ghent University Hospital, Ghent, Belgium. 3. Department of Intensive Care Medicine, Ghent University Hospital, Ghent, Belgium. 4. Renal Division, Ghent University Hospital, Ghent, Belgium. 5. Department of Intensive Care Medicine, Ghent University Hospital, Ghent, Belgium; Research Foundation Flanders, Belgium.
Abstract
PURPOSE: Severe lactic acidosis (SLA) is frequent in intensive care unit (ICU) patients with acute kidney injury (AKI) treated with renal replacement therapy (RRT). The aim of the study is to describe the epidemiology of SLA in this setting. MATERIALS AND METHODS: An observational single-center cohort analysis was performed on AKI patients treated with RRT. At initiation of RRT, SLA patients (serum lactate concentration>5 mmol/L and pH<7.35) were compared with non-SLA patients. RESULTS: Of the 454 patients dialyzed during the study period, 342 patients matched inclusion criteria (116 with and 226 patients without SLA). In SLA patients, lactate stabilized/decreased in 69.7% at 4 hours (P=.001) and in 81.8% during the period of 4 to 24 hours (P<.001) after initiation of RRT. Mortality during this 24-hour period was 31.0%. Intensive care unit mortality was 83.6% compared with 47.3% in non-SLA patients. Initial lactate concentration was not related to ICU mortality in SLA patients. CONCLUSIONS: Severe lactic acidosis was frequent in AKI patients treated with RRT. Severe lactic acidosis patients were more severely ill and had higher mortality compared with patients without. During the first 24 hours of RRT, a correction of lactate concentration and acidosis was observed. In SLA patients, lactate concentration at initiation of RRT was not able to discriminate between survivors and nonsurvivors.
PURPOSE: Severe lactic acidosis (SLA) is frequent in intensive care unit (ICU) patients with acute kidney injury (AKI) treated with renal replacement therapy (RRT). The aim of the study is to describe the epidemiology of SLA in this setting. MATERIALS AND METHODS: An observational single-center cohort analysis was performed on AKI patients treated with RRT. At initiation of RRT, SLA patients (serum lactate concentration>5 mmol/L and pH<7.35) were compared with non-SLA patients. RESULTS: Of the 454 patients dialyzed during the study period, 342 patients matched inclusion criteria (116 with and 226 patients without SLA). In SLA patients, lactate stabilized/decreased in 69.7% at 4 hours (P=.001) and in 81.8% during the period of 4 to 24 hours (P<.001) after initiation of RRT. Mortality during this 24-hour period was 31.0%. Intensive care unit mortality was 83.6% compared with 47.3% in non-SLA patients. Initial lactate concentration was not related to ICU mortality in SLA patients. CONCLUSIONS: Severe lactic acidosis was frequent in AKI patients treated with RRT. Severe lactic acidosispatients were more severely ill and had higher mortality compared with patients without. During the first 24 hours of RRT, a correction of lactate concentration and acidosis was observed. In SLA patients, lactate concentration at initiation of RRT was not able to discriminate between survivors and nonsurvivors.
Authors: M Schmitz; P J Heering; R Hutagalung; R Schindler; M I Quintel; F M Brunkhorst; S John; A Jörres Journal: Med Klin Intensivmed Notfmed Date: 2015-03-28 Impact factor: 0.840
Authors: Chun Chieh Chu; Chih Min Su; Fu Cheng Chen; Chi Yung Cheng; Hsien Hung Cheng; Chia Te Kung Journal: Medicine (Baltimore) Date: 2021-02-19 Impact factor: 1.817
Authors: Wouter De Corte; Annemieke Dhondt; Raymond Vanholder; Jan De Waele; Johan Decruyenaere; Veerle Sergoyne; Joke Vanhalst; Stefaan Claus; Eric A J Hoste Journal: Crit Care Date: 2016-08-12 Impact factor: 9.097