title: [The effect of early goal lactate clearance rate on the outcome of septic shock patients with severe pneumonia].
abstract: OBJECTIVE
  To observe the clinical effects of 10%, 30% lactate clearance rate and early goal-directed therapy (EGDT) as 6-hour resuscitation goals directing treatment in septic shock patients with severe pneumonia.
  
  
  METHODS
  In this randomized, perspective study, septic shock patients with severe pneumonia were divided into control group and experimental group, which included 10% lactate clearance rate group and 30% lactate clearance rate group, adopting random number method. The control group was treated with 6-hour EGDT strategy, and the experimental groups were treated with 10% lactate clearance rate protocol and 30% lactate clearance rate protocol respectively, beside the EGDT.
  
  
  RESULTS
  There were 19 patients in control group, and 43 patients in experimental group, which included 22 patients in 10% lactate clearance rate group and 21 patients in 30% lactate clearance rate group. Patients were well matched by basic features. After 48 hours, the acute physiology and chronic health evaluation II (APACHE II ) score of both 10% lactate clearance rate group (13.76 ± 6.00, P < 0.05) and 30% lactate clearance rate group (13.60 ± 6.18, P < 0.05) were lower than that of control group (18.15 ± 6.62). There were no differences in time of mechanical ventilation (hours) between control group and experimental group (10% group 136.90 ± 100.02, 30% group 97.00 ± 75.20, control group 152.32 ± 96.51, P > 0.05). The length in intensive care unit (ICU, days) of 10% and 30% lactate clearance rate groups were significantly shorter than control group (10% group 7.94 ± 6.00, 30% group 7.51 ± 3.99, control group 11.31 ± 5.97, both P < 0.05). The three groups had no differences in 7-day mortality rate (10% group 18.18%, 30% group 14.29%, control group 21.05%, all P > 0.05), but the 28-day mortality of 10% and 30% lactate clearance rate groups were significantly lower than control group (10% group 36.36%, 30% group 28.57%, control group 63.16%), especially in 30% lactate clearance rate group (P < 0.05).
  
  
  CONCLUSIONS
  For the septic shock patients with severe pneumonia, prompt archiving EGDT strategy and 6-hour lactate clearance more than 30% were associated with an optimal outcome.
authors.affiliation: Binzhou Medical University Clinical Department, Binzhou, Shandong, China.
authors.forename: Huan-huan
authors.initials: HH
authors.lastname: Tian
authors.forename: Sha-sha
authors.initials: SS
authors.lastname: Han
authors.forename: Chang-jun
authors.initials: CJ
authors.lastname: Lv
authors.forename: Tao
authors.initials: T
authors.lastname: Wang
authors.forename: Zhi
authors.initials: Z
authors.lastname: Li
authors.forename: Dong
authors.initials: D
authors.lastname: Hao
authors.forename: Quan-mei
authors.initials: QM
authors.lastname: Shang
authors.forename: Xiao-zhi
authors.initials: XZ
authors.lastname: Wang
mesh_terms: D000328:Adult; D000368:Aged; D005260:Female; D006801:Humans; D007362:Intensive Care Units; D019344:Lactic Acid / Q000378:metabolism*; D008297:Male; D008657:Metabolic Clearance Rate; D008875:Middle Aged; D011014:Pneumonia / Q000150:complications / Q000378:metabolism / Q000628:therapy; D011446:Prospective Studies; D012151:Resuscitation / Q000379:methods*; D012772:Shock, Septic / Q000209:etiology / Q000378:metabolism / Q000628:therapy*
chemical_list: D019344:Lactic Acid