Correlation between early sublingual small vessel density and late blood lactate level in critically ill surgical patients.
BACKGROUND
Surgical stress may cause excessive inflammation and lead to microcirculatory dysfunction. The hypothesis of this study was that early microcirculatory dysfunction may result in anaerobic glycolysis and lead to elevated blood lactate levels in patients admitted to surgical intensive care units.


METHODS
This prospective observational study enrolled adult patients admitted to surgical intensive care units after general surgery or thoracic surgery. We measured blood lactate levels before the operation and at 1 h and 24 h after the operation. We obtained images of sublingual microcirculation using a sidestream dark field video microscope and analyzed them employing automated analysis software.


RESULTS
A total of 31 patients completed the study. Perioperative total and perfused small vessel densities were lower in patients with a blood lactate level ≥3 mmol/L. We observed a significant correlation between the total small vessel density at 1 h and the blood lactate level at 24 h (r = -0.573; P = 0.001). In addition, we saw a significant correlation between the perfused small vessel density at 1 h and the blood lactate level at 24 h (r = -0.476; P = 0.008).


CONCLUSIONS
Early total and perfused small vessel density may be used as an early predictor or therapeutic goal for critically ill surgical patients in further studies.
Department of Anesthesiology, National Taiwan University Hospital, Taipei, Taiwan.
Yu-Chang
YC
Yeh
Ming-Jiuh
MJ
Wang
Anne
A
Chao
Wen-Je
WJ
Ko
Wing-Sum
WS
Chan
Shou-Zen
SZ
Fan
Jui-Chang
JC
Tsai
Wei-Zen
WZ
Sun
D000328:Adult; D000368:Aged; D016638:Critical Illness; D005260:Female; D006801:Humans; D019344:Lactic Acid / Q000097:blood*; D008297:Male; D008833:Microcirculation; D008875:Middle Aged; D009060:Mouth Floor / Q000098:blood supply*; D011446:Prospective Studies; D013514:Surgical Procedures, Operative
D019344:Lactic Acid