Hyperlactatemia in Sepsis in Patients Admitted in Intensive Care Unit

Abstract

Introduction: Sepsis is a systemic, deleterious host response to infection leading to severe sepsis (acute organ dysfunction secondary to documented or suspected infection) and septic shock. Sepsis is a contributing factor in >200,000 deaths per year in the United States. The incidence of severe sepsis and septic shock has increased over the past 30 years, and the annual number of cases is now >750,000 (~3 per 1000 population). With a population of 1.22 billion, today India is grappling with various health issues. As sepsis is very common in patients admitted to ICU, so the early diagnosis and severity of the sepsis should be an important step in the management of sepsis. It has been suggested that as the level of lactate increase, the severity of sepsis is more. So, we planned to see the lactate level in patients of sepsis, and its correlation with patients of sepsis admitted to our hospital in ICU. Methodology: This prospective study was carried out in Medicine department of SBKS Medical Institute and research center, Piparia, Vadodara. A total number of 50 patients of sepsis were included in the study as per the inclusion and exclusion criteria. All included participants were subject to Arterial blood gas analysis for Lactate level, CBC, RFT, LFT, RBS, Urine RM, ESR, chest X-ray, USG Abdomen. Laboratory evaluations were performed in the institutional pathology and biochemistry labs. Results: Total 50 patients were included in the study and were analyzed. Most common presenting complaint was fever, breathlessness, altered sensorium. Most common source of sepsis were urinary tract infection, lung, and abdomen. Over all urea and creatinine were increased, and there was increased bilirubin, SGPT, SGOT in most of the patients. The mortality rate was 58.8 % for patients with a lactate level greater than or equal to 2.0 mmol/mm3 clearly demonstrates that a lactate level may be helpful in identifying a high-risk patient population in the ICU, patient who were discharged had significantly lesser lactate level than patients who died (p-0.020). Conclusion: Lactate level is a very important prognostic marker in sepsis. If the initial lactate level is high the patient is more likely to die, so according to the level of initial lactate level the risk can be judged.