title: THE ROLE OF LACTATE CLEARANCE AS A PREDICTOR OF ORGAN DYSFUNCTION AND MORTALITY IN PATIENTS WITH SEVERE SEPSIS.
abstract: BACKGROUND
  Little is known about biomarkers which are used to classification of patients in order to diagnosis severity of sepsis among clients of emergency units. It seems that Lactate's clearance can be used in this regard. This study aimed to determine the relationship between Lactate's clearance, mortality and organ's dysfunction with severe sepsis.
  
  
  METHODS
  In this study 90 patients with severe sepsis, were visited and examined exactly. Para clinical tests, serum venous lactate, organ's dysfunction scores, Acute Physiology and Chronic Health Evaluation II (APACHE-II) and Sequential Organ Failure Assessment (SOFA) were applied upon admission and 6 hours after it. According to clinical and laboratory criteria, dysfunction in main organs were examined and Lactate's Clearance was accounted. All the patients were cured according to early goal-directed therapy protocol.
  
  
  RESULTS
  Among the participants 49 and 41 were male and female respectively. The mean age of the group was 49.37±1.41. The patients were classified to groups, less or more than 10% lactate's clearance. Mortality rate of the patients was 18.9% (17 people). Mean age of the dead group was 49.71±13.33. The mean of dysfunctional organs which is assessed in terms of clinical, laboratory and SOFA criteria was significantly higher among the dead group than other. The Lactate's clearance in the dead group was significantly lower than the other group (p<.05).
  
  
  CONCLUSIONS
  It was concluded that patients with severe sepsis is a marker which is related to tissue hypoxia, also lactate's clearance increasing is related to drastic reduction in biomarkers, mortality, and incidence of organ's dysfunction. Overall, patients with lower lactate's clearance are counted a high risk group for mortality and organs' dysfunction.
authors.affiliation: Department of Emergency Medicine, Mashhad University of Medical Sciences, Mashhad, Iran.
authors.forename: Ehsan
authors.initials: E
authors.lastname: Bolvardi
authors.affiliation: Department of Emergency Medicine, Mashhad University of Medical Sciences, Mashhad, Iran.
authors.forename: Jafar
authors.initials: J
authors.lastname: Malmir
authors.affiliation: Department of Emergency Medicine, Mashhad University of Medical Sciences, Mashhad, Iran.
authors.forename: Hamidreza
authors.initials: H
authors.lastname: Reihani
authors.affiliation: Department of Emergency Medicine, Mashhad University of Medical Sciences, Mashhad, Iran.
authors.forename: Amir Masoud
authors.initials: AM
authors.lastname: Hashemian
authors.affiliation: Department of Emergency Medicine, Alborz University of Medical Sciences, Karaj, Iran.
authors.forename: Mehran
authors.initials: M
authors.lastname: Bahramian
authors.affiliation: Department of Emergency Medicine, Alborz University of Medical Sciences, Karaj, Iran.
authors.forename: Peyman
authors.initials: P
authors.lastname: Khademhosseini
authors.affiliation: Department of Emergency Medicine, Alborz University of Medical Sciences, Karaj, Iran.
authors.forename: Koorosh
authors.initials: K
authors.lastname: Ahmadi
keywords: lactate; organ dysfunction; prognosis; severe sepsis