Use of Lactate Clearance as a Predictor of Mortality Rate after Initial Resuscitation in Patient with Severe Sepsis or Septic Shock

Abstract

Severe sepsis and septic shock are affecting millions of people around the world each year. They are the commonest causes of morbidity and mortality in intensive care. Early diagnosis of sepsis is the key for improving the survival. Culture is the diagnostic tool but the microbiological origin of infection is demonstrated in about 2/3rd of cases. Biomarkers have an important place in this process because they can indicate the presence or absence of sepsis and detect cause of infection. They are also important in evaluating the response to therapy and recovery from sepsis. Lactate level may be very useful for assessing critical patients, especially those with sepsis. However, one single lactate level is not as valuable as serial lactate levels throughout the course of sepsis. Lactate is the end product of anaerobic glycolysis which occur under hypoxic conditions in hypo perfused tissues during severe sepsis or septic shock. It is normally metabolized in liver mainly (60%). Kidneys and heart also participate in its metabolism. But in patients with septic shock, the previously mentioned organs are hypoperfused