Tag: lactate
The predictive value of LAR for determining the need for ICU admission among hospitalized patients with community-acquired pneumonia
In this study, lactate-to-albumin ratio (LAR) was found to be a good predictor of ICU admissions in hospitalized patients with CAP and was non-inferior to PSI or CURB-65 scores. LAR was found to be a good predictor of... read more
Lactated Ringer’s a Clear Winner for Pancreatitis Resuscitation
Pancreatitis, a common and challenging condition, presents frequently in emergency departments across the country, affecting around 34 of every 100,000 adults annually. This often-severe disease is marked by inflammation... read more
Septic Shock in the Prehospital Setting
Septic shock (SS) is a potential life-threatening condition in which an early identification and immediate therapy stand out as the main cornerstones to improve survival chance; in this context, emergency medical services... read more
Effect of Different Shock Conditions on Mesenteric Hemodynamics
The velocity parameters of SMA Doppler ultrasound such as TAMV and PSV can reflect cardiac function. The measurements of SMA RI and PI are correlated with lactate levels, having a positive predictive value for hyperlactatemia... read more
Complex Infusion Volumes Interaction and Confounding Factors with Lactate Clearance in Septic Shock
A recent article by Ahlstedt et al. published in Intensive Care Medicine examining the impact of restrictive fluid management on lactate clearance in septic shock patients within the intensive care unit (ICU) piqued our interest.... read more
Roadblock: AFib with RVR
In this paper we focus on strategies to bypass the most common pitfalls in our treatment algorithm when treating patients who present to the ED in atrial fibrillation with RVR. We all know the few medications in our toolbox... read more
CRT-targeted Fluid Resuscitation vs. Lactate-targeted in Septic Shock
Capillary refill time (CRT)-targeted fluid resuscitation in septic shock was not superior to a lactate-targeted one on early fluid administration or fluid balances. However, it was associated with comparable effects on regional... read more
Arterial pH with Hemodynamic Response Association to Vasopressin in Patients with Septic Shock
Compared with higher arterial pH, patients with septic shock and low arterial pH had lower odds of vasopressin response and higher catecholamine doses after vasopressin initiation. Similar to other vasopressors, the clinical... read more
Respiratory Drive in Sepsis and Septic Shock Patients: Modulation by High-flow Nasal Cannula
Patients with sepsis and septic shock of extrapulmonary origin present elevated respiratory drive and effort, which can be effectively reduced by high-flow nasal cannula. 25 nonintubated patients with extrapulmonary sepsis... read more
Outcome After Intubation for Septic Shock with Respiratory Distress and Hemodynamic Compromise
Intubation within 24 h of sepsis was not associated with hospital mortality but resulted in fewer 28-day hospital-free days. Although intubation remains a high-risk procedure, we did not identify an increased risk in mortality... read more
Pre-hospital suPAR, Lactate and CRP Measurements for Decision-making
Pre-hospital suPAR measurements alone or combined with C-reactive protein (CRP) and/or lactate measurements could not predict the ED discharge or hospital admission of 109 non-urgent EMS patients with non-specific chief complaints... read more
Lactated Ringers is Safe in Hyperkalemia, and is Superior to NS
The myth that LR should be avoided in hyperkalemia is not only incorrect, it is probably backwards. For a hyperkalemic patient in renal failure, Lactated Ringers (LR) should be preferred over normal saline (NS). LR has been... read more
Lactate = LactHATE
Like many others who attended SMACC earlier this year I returned home dazed and confused about the significance of lactate in the septic patient. So like any good (aspiring to be) evidence-based medicine practitioner,... read more
Cytokine Adsorption Effect on Survival and Circulatory Stabilization in Patients Receiving ECPR
Even after the introduction of extracorporeal cardiopulmonary resuscitation (ECPR), survival after cardiac arrest remains poor. Excess release of vasoactive cytokines may be a reason for cardiovascular instability and death... read more
Validation of a Point-of-Care Capillary Lactate Measuring Device
Lactate Pro 2 had good agreement with the reference method using arterial blood but poorer agreement using venous blood. Our results show the potential for overestimation of the lactate values in haemodynamically compromised... read more
What’s Working for COVID-19 Patients in the Epicenter
Our large tertiary care ED in Queens, NY, usually sees more than 100,000 adults a year. As we write this, we have 850 COVID-19-likely or -positive patients (several hundred above our bed capacity just one month ago), more... read more
Epinephrine Challenge in Sepsis: An Empiric Approach to Catecholamines
The critical care world is obsessed with fluid. Meanwhile, little attention has been given to the concepts of vasopressor responsiveness and vasopressor challenge. This is a missed opportunity, because vasopressor challenges... read more
