title: Plasma lactate concentrations in septic peritonitis: A retrospective study of 83 dogs (2007-2012).
abstract: OBJECTIVE
  To determine if absolute plasma lactate concentration or lactate clearance in dogs with septic peritonitis is associated with morbidity or mortality.
  
  
  METHODS
  Retrospective cohort study from 2007 to 2012.
  
  
  METHODS
  University teaching hospital.
  
  
  METHODS
  Eighty-three dogs with septic peritonitis were included. Patients had at least 1 plasma lactate measurement during the course of the hospitalization.
  
  
  RESULTS
  Sixty-four percent of the patients survived to discharge, 22% were euthanized, and 14% died during hospitalization. Plasma lactate concentration >2.5 mmol/L on admission (29% of the patients) was associated with mortality (P = 0.001). Median admission plasma lactate concentration (n = 81) was significantly different between nonsurvivors (2.5 mmol/L, range 0.5-8.4) and survivors (1.4 mmol/L, range 0.5-9.7; P = 0.007). Admission plasma lactate concentration >4 mmol/L yielded a sensitivity of 36% and a specificity of 92% for nonsurvival. The inability to normalize plasma lactate concentration within 6 hours of admission (n = 10/24) yielded a sensitivity of 76% and specificity of 100% for nonsurvival. Postoperative hyperlactatemia (plasma lactate concentration >2 mmol/L; n = 18/76) had a sensitivity of 46% and specificity of 88% for nonsurvival. Persistent postoperative hyperlactatemia (n = 11/18) had a sensitivity of 92% and a specificity of 100% for nonsurvival. Lactate clearance less than 21% at 6 hours (n = 20) had a sensitivity of 54% and specificity of 91% for nonsurvival. Lactate clearance less than 42% at 12 hours (n = 18) had a sensitivity of 82% and a specificity of 100% for nonsurvival.
  
  
  CONCLUSIONS
  Admission plasma lactate concentration and lactate clearance were good prognostic indicators in dogs with septic peritonitis.
authors.affiliation: Department of Clinical Science and Services, The Royal Veterinary College, North Mymms, Hertfordshire, AL9 7TA, United Kingdom.
authors.forename: Stefano
authors.initials: S
authors.lastname: Cortellini
authors.affiliation: Animal Health Trust, Small Animal Centre, Kentford, Newmarket, Suffolk, CB8 7UU, United Kingdom.
authors.forename: Mayank
authors.initials: M
authors.lastname: Seth
authors.affiliation: Department of Clinical Science and Services, The Royal Veterinary College, North Mymms, Hertfordshire, AL9 7TA, United Kingdom.
authors.forename: Lindsay M
authors.initials: LM
authors.lastname: Kellett-Gregory
mesh_terms: D000818:Animals; D015415:Biomarkers / Q000097:blood*; D015331:Cohort Studies; D003422:Critical Care; D004283:Dog Diseases / Q000097:blood*; D004285:Dogs; D005260:Female; D019344:Lactic Acid / Q000097:blood*; D008297:Male; D010538:Peritonitis / Q000097:blood / Q000662:veterinary*; D011183:Postoperative Complications / Q000097:blood / Q000662:veterinary*; D011379:Prognosis; D012189:Retrospective Studies; D012680:Sensitivity and Specificity; D012772:Shock, Septic / Q000097:blood / Q000662:veterinary*; D014730:Veterinary Medicine
chemical_list: D015415:Biomarkers; D019344:Lactic Acid
keywords: canine; lactime; outcome; sepsis; shock; survival