Lactate concentrations in the rectal lumen in patients in early septic shock
Version of Record online: 15 JUN 2010
© 2010 The Authors. Journal compilation © 2010 The Acta Anaesthesiologica Scandinavica Foundation
Acta Anaesthesiologica Scandinavica
Volume 54, Issue 7, pages 827–832, August 2010
How to Cite
IBSEN, M., TENHUNEN, J., WIIS, J., WALDAU, T., LAURITSEN, A. Ø., THORNBERG, K., JOENSEN, H. and Perner, A. (2010), Lactate concentrations in the rectal lumen in patients in early septic shock. Acta Anaesthesiologica Scandinavica, 54: 827–832. doi: 10.1111/j.1399-6576.2010.02263.x
- Issue online: 5 JUL 2010
- Version of Record online: 15 JUN 2010
- Accepted for publication 18 May 2010
Background: Previously, we observed that rectal luminal lactate was higher in non-survivors compared with survivors of severe sepsis or septic shock persisting >24 h. The present study was initiated to further investigate this tentative association between rectal luminal lactate and mortality in a larger population of patients in early septic shock.
Methods: A prospective observational multicentre study of 130 patients with septic shock at six general ICU's of university hospitals. Six to 24 h after the onset of septic shock, the concentration of lactate in the rectal lumen was estimated by a 4-h equilibrium dialysis. Dialysate concentrations of lactate were determined using an auto-analyser.
Results: The overall 30-day mortality was 32%, with age and Simplified acute physiology scores II and sequential organ failure assessment scores being significantly higher in non-survivors. In contrast, there were no differences in concentrations of lactate in the rectal lumen [2.2 (1.4–4.1) and 2.8 (1.6–5.1) mmol/l (P=0.34)] (medians and 25th–75th percentiles) or arterial blood [2.1 (1.4–4.2) and 2.0 (1.3–3.2) mmol/l (P=0.15)] between non-survivors and survivors. The rectal–arterial difference of the lactate concentration was higher in survivors. There were no differences in blood pressure, noradrenaline dose or central venous oxygen saturation between the groups.
Conclusion: In this prospective, observational study of unselected patients with early septic shock, there was no difference in the concentration of lactate in the rectal lumen between non-survivors and survivors.
Trial Registration: Clinicaltrials.gov (no: NCT00197938).