title: [Relationship between blood lactic level, lactic clearance, duration of lacticemia and prognosis of critically ill patients in intensive care unit].
abstract: OBJECTIVE
  To study and quantify the relationship between dynamic lactic acid monitoring indexes and prognosis of critically ill patients in intensive care unit (ICU).
  
  
  METHODS
  One hundred and one critically ill patients with elevated blood lactic acid level were included in this study and divided into death group (n=50) and survival group (n=51). Differences in their lactic acid indexes (including: lactic acid level, duration of lacticemia, lactic clearance), acute physiology and chronic health evaluation II (APACHEII) score, and other clinical indicators which reflected organ/system status were compared, and prognostic significant lacticemia indexes were formulated by multi-variable logistic analysis. Subsequently, patients were grouped by significant lactic indexes separately and compared with incidence of shock/multiple organ dysfunction syndrome (MODS), APACHE II score and mortality.
  
  
  RESULTS
  Differences in lactic acid level, peak lactic acid level, 12-hour and 24-hour lactic acid clearance between death group and survival group showed statistically significant difference (P<0.05 or P<0.01). Peak lactic acid level, 12-hour lactic clearance, APACHE II score and blood pH had significant correlation with prognosis, odds ratios (OR) were 1.466, 0.922, 1.208, 0.032, respectively. Patients with peak lactic acid value> or =10 mmol/L or 12-hour lactic clearance< or =10% had significantly higher mortality: 77.8% and 70.6%, respectively (P<0.05 and P<0.01). Although patients with lacticemia>24 hours had higher mortality, there was no statistically significant difference.
  
  
  CONCLUSIONS
  Peak lactic acid level, 12-hour lactic clearance, APACHE II score and blood pH are good indicators to evaluate patients' prognosis. Peak lactic acid value> or =10 mmol/L or 12-hour lactic clearance< or =10% is an alert of extremely bad prognosis. Prognosis value of duration of lacticemia is limited.
authors: Intensive Care Unit Department, Qilu Hospital of Shandong University, Jinan 250012, Shandong, China. wanghao34@126.com
authors: Hao
authors: H
authors: Wang
authors: Da-wei
authors: DW
authors: Wu
authors: Xiao-mei
authors: XM
authors: Chen
authors: Chen
authors: C
authors: Li
authors: Shi-fang
authors: SF
authors: Ding
authors: Qian
authors: Q
authors: Zhai
authors: Bin-feng
authors: BF
authors: Du
authors: Yuan
authors: Y
authors: Li
authors: Ke-fu
authors: KF
authors: Wang
mesh_terms: D018806:APACHE; D000328:Adult; D000368:Aged; D016638:Critical Illness; D005260:Female; D006801:Humans; D007362:Intensive Care Units; D019344:Lactic Acid / Q000097:blood*; D016015:Logistic Models; D008297:Male; D008657:Metabolic Clearance Rate; D008875:Middle Aged; D011379:Prognosis
chemical_list: D019344:Lactic Acid