BLOOD LACATE LEVELS AS PROGNOSTIC MARKER IN SEPSIS

Dr. Raveesha A*, Dr. Rahul V, Dr. Prabhakar K, Dr. Lakshmaiah V, Dr. Raghavendra Prasad BN, Dr. Reddy Prasad K.

ABSTRACT

Objectives: 1. To study the role of blood lactate levels in sepsis., 2. To study blood lactate levels in sepsis in relation to survival outcome. Materials and methods: This is an observational cohort study done in 67 patients admitted to R.L. Jalappa Hospital. Subject’s history and clinical examination suggestive of sepsis satisfying the inclusion and exclusion criteria were taken into the study. Arterial Blood lactate levels were measured at the time of admission, 12 hours, 24 hours and 36 hours by using epoc blood gas analyzer. Relevant investigations including haemogram, blood gas analysis, blood urea, serum creatinine, electrocardiogram and x-ray were done. The patients were followed till the time of discharge or death. Results: The mean arterial blood lactate levels at the time of admission, 12 hours, 24 hours, 36 hours in sepsis patients who survived are 3.47 ± 3.21, 2.86 ± 2.89, 2.19 ± 1.49, 1.84 ± 0.81mmol/lit respectively and mean blood lactate levels in non survivors are 5.61 ± 3.75, 4.75 ± 3.28, 3.60 ± 1.94, 2.42 ± 1.84 mmol/lit at the time of admission, 12 hours, 24 hours, 36 hours respectively. There was a significant association between blood lactate levels and outcome. In the non-survivors lactate levels was found to be greater than 4 mmol/lit in 64% patients. At admission sensitivity and specificity for lactate in predicting mortality is 76.5% and 30% respectively. Lactate levels at 24 hours has got much higher sensitivity of 77.8% and specificity of 32% in predicting mortality. Conclusion: Arterial blood lactate is elevated in sepsis patients and there is an increased risk of mortality if the elevation is above 4 mmol/lit.

Keywords: sepsis, arterial blood lactate, prognostic marker.