AbbreviationsAUROCarea under the receiver operating characteristic curveAPPLEacute patient physiologic and laboratory evaluationCIconfidence intervalEDemergency departmentGDVgastric dilation and volvulusICUintensive care unit[LAC]lactate concentration/sNPVnegative predictive valueORodds ratioPPVpositive predictive valueScvO2central venous oxygen saturationSOFAsequential organ failure assessmentSIRSsystemic inflammatory response syndromeIntroductionIncreased lactate concentrations ([LAC]) are associated with increased disease severity, morbidity, and mortality in many ill and injured human and veterinary populations. The first part of this review discussed the physiology, pathophysiology, and measurement of lactate. This second part evaluates the clinical utility of lactate as a prognostic indicator and therapeutic guide, the value of measuring lactate concentrations in body fluids other than blood, and the clinical management of hyperlactatemia.TerminologyThere is some confusion in the literature regarding the terminology used to describe the measurement of [LAC]. To encourage standardization and to clarify our intended meaning, the following definitions are used:Admission [LAC]: The first sample obtained as soon as practicable on admission to a facility.Initial [LAC]: The first sample obtained; usually, but not necessarily, on admission.Single, subsequent time point: A single, [LAC] measurement performed subsequent to the first.Serial [LAC]: One or more subsequent lactate measurements following the first.Relative measure: A variable calculated by comparing 2 or more [LAC] measurements over time, for example absolute change, % change.Lactate
Journal of Veterinary Emergency and Critical Care – Wiley
Published: Jan 1, 2018
Keywords: ; ; ; ; ; ; ; ;
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