[Lactate as a predictor of mortality and multiple organ failure in patients with the systemic inflammatory response syndrome.].
OBJECTIVE
The systemic inflammatory response syndrome (SIRS) is common in the postoperative period of critically ill patients. The objective of this study was to investigate the correlation between lactate level, multiple organ dysfunction, and mortality in patients with SIRS.


METHODS
This prospective study evaluated 24 patients with a postoperative diagnosis of SIRS (American College of Chest Physicians/Society of Critical Care Medicine) in the surgical ICU. Lactate levels were determined in the first 24 hours after the diagnosis of SIRS and daily, for 7 days. Patients were divided in 2 groups: LE Group (lactate > 2 mmol.L-1) and LN Group (lactate < 2 mmol.L-1). Multiple organ failure was evaluated by the SOFA (Sequential Organ Failure Assessment) score daily, for 7 days. After the 7-day follow-up period patients were followed for up to 28 days, until discharge from the hospital or death.


RESULTS
Thirteen patients were included in the LE Group after the diagnosis of SIRS and 11 patients in the LN Group. The relative risk (RR) of death in 7 days for the LE Group was 4.23 (CI 95% 2.25-7.95) times greater than in the LN Group in the first day of the study. The RR of death in 28 days was 1.7 times greater for the LE Group (CI 95% 0.84-3.46). The SOFA score was similar in both groups.


CONCLUSIONS
Patients with elevated lactate in the first 24 hours after the diagnosis of SIRS did not have more organic dysfunction than patients with normal lactate levels, but they had an increased risk of death in 7 days.
Cicarelli
Domingos Dias
DD
HC, FM, USP.
Vieira
Joaquim Edson
JE
Benseñor
Fábio Ely Martins
FE