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ERDOĞAN, Hasan, Songül ERDOĞAN, Tahir Özalp, İsmail Günal e Kerem URAL. "L-Lactate Levels Calves With Pneumonia". Journal of Advances in VetBio Science and Techniques 3, n.º 2 (31 de agosto de 2018): 38–42. http://dx.doi.org/10.31797/vetbio.433468.
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Tongyoo, Surat, Kamonlawat Sutthipool, Tanuwong Viarasilpa e Chairat Permpikul. "Serum lactate levels in cirrhosis and non-cirrhosis patients with septic shock". Acute and Critical Care 37, n.º 1 (28 de fevereiro de 2022): 108–17. http://dx.doi.org/10.4266/acc.2021.00332.
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Background: In septic shock patients with cirrhosis, impaired liver function might decrease lactate elimination and produce a higher lactate level. This study investigated differences in initial lactate, lactate clearance, and lactate utility between cirrhotic and non-cirrhotic septic shock patients.Methods: This is a retrospective cohort study conducted at a referral, university-affiliated medical center. We enrolled adults admitted during 2012–2018 who satisfied the septic shock diagnostic criteria of the Surviving Sepsis Campaign: 2012. Patients previously diagnosed with cirrhosis by an imaging modality were classified into the cirrhosis group. The initial lactate levels and levels 6 hours after resuscitation were measured and used to calculate lactate clearance. We compared initial lactate, lactate at 6 hours, and lactate clearance between the cirrhosis and non-cirrhosis groups. The primary outcome was in-hospital mortality.Results: Overall 777 patients were enrolled, of whom 91 had previously been diagnosed with cirrhosis. Initial lactate and lactate at 6 hours were both significantly higher in cirrhosis patients, but there was no difference between the groups in lactate clearance. A receiver operating characteristic curve analysis for predictors of in-hospital mortality revealed cut-off values for initial lactate, lactate at 6 hours, and lactate clearance of >4 mmol/L, >2 mmol/L, and <10%, respectively, among non-cirrhosis patients. Among patients with cirrhosis, the cut-off values predicting in-hospital mortality were >5 mmol/L, >5 mmol/L, and <20%, respectively. Neither lactate level nor lactate clearance was an independent risk factor for in-hospital mortality among cirrhotic and non-cirrhotic septic shock patients.Conclusions: The initial lactate level and lactate at 6 hours were significantly higher in cirrhosis patients than in non-cirrhosis patients.
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Biancari, Fausto, Antonio Fiore, Kristján Jónsson, Giuseppe Gatti, Svante Zipfel, Vito G. Ruggieri, Andrea Perrotti et al. "Prognostic Significance of Arterial Lactate Levels at Weaning from Postcardiotomy Venoarterial Extracorporeal Membrane Oxygenation". Journal of Clinical Medicine 8, n.º 12 (15 de dezembro de 2019): 2218. http://dx.doi.org/10.3390/jcm8122218.
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Background: The outcome after weaning from postcardiotomy venoarterial extracorporeal membrane oxygenation (VA-ECMO) is poor. In this study, we investigated the prognostic impact of arterial lactate levels at the time of weaning from postcardiotomy VA. Methods: This analysis included 338 patients from the multicenter PC-ECMO registry with available data on arterial lactate levels at weaning from VA-ECMO. Results: Arterial lactate levels at weaning from VA-ECMO (adjusted OR 1.426, 95%CI 1.157–1.758) was an independent predictor of hospital mortality, and its best cutoff values was 1.6 mmol/L (<1.6 mmol/L, 26.2% vs. ≥ 1.6 mmol/L, 45.0%; adjusted OR 2.489, 95%CI 1.374–4.505). When 261 patients with arterial lactate at VA-ECMO weaning ≤2.0 mmol/L were analyzed, a cutoff of arterial lactate of 1.4 mmol/L for prediction of hospital mortality was identified (<1.4 mmol/L, 24.2% vs. ≥1.4 mmol/L, 38.5%, p = 0.014). Among 87 propensity score-matched pairs, hospital mortality was significantly higher in patients with arterial lactate ≥1.4 mmol/L (39.1% vs. 23.0%, p = 0.029) compared to those with lower arterial lactate. Conclusions: Increased arterial lactate levels at the time of weaning from postcardiotomy VA-ECMO increases significantly the risk of hospital mortality. Arterial lactate may be useful in guiding optimal timing of VA-ECMO weaning.
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Scheijen, Jean L. J. M., Nordin M. J. Hanssen, Marjo P. H. van de Waarenburg, Daisy M. A. E. Jonkers, Coen D. A. Stehouwer e Casper G. Schalkwijk. "L(+) and D(-) Lactate Are Increased in Plasma and Urine Samples of Type 2 Diabetes as Measured by a Simultaneous Quantification of L(+) and D(-) Lactate by Reversed-Phase Liquid Chromatography Tandem Mass Spectrometry". Experimental Diabetes Research 2012 (2012): 1–10. http://dx.doi.org/10.1155/2012/234812.
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Background. Plasma and urinary levels of D-lactate have been linked to the presence of diabetes. Previously developed techniques have shown several limitations to further evaluate D-lactate as a biomarker for this condition.Methods. D- and L-lactate were quantified using ultraperformance liquid chromatography tandem mass spectrometry with labelled internal standard. Samples were derivatized with diacetyl-L-tartaric anhydride and separated on a C18-reversed phase column. D- and L-lactate were analysed in plasma and urine of controls, patients with inflammatory bowel disease (IBD), and patients with type 2 diabetes (T2DM).Results. Quantitative analysis of D- and L-lactate was achieved successfully. Calibration curves were linear (r2>0.99) over the physiological and pathophysiological ranges. Recoveries for urine and plasma were between 96% and 113%. Inter- and intra-assay variations were between 2% and 9%. The limits of detection of D-lactate and L-lactate in plasma were 0.7 μmol/L and 0.2 μmol/L, respectively. The limits of detection of D-lactate and L-lactate in urine were 8.1 nmol/mmol creatinine and 4.4 nmol/mmol creatinine, respectively. Plasma and urinary levels of D- and L-lactate were increased in patients with IBD and T2DM as compared with controls.Conclusion. The presented method proved to be suitable for the quantification of D- and L-lactate and opens the possibility to explore the use of D-lactate as a biomarker.
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Stansen, Corinna, Davin Uy, Stephane Delaunay, Lothar Eggeling, Jean-Louis Goergen e Volker F. Wendisch. "Characterization of a Corynebacterium glutamicum Lactate Utilization Operon Induced during Temperature-Triggered Glutamate Production". Applied and Environmental Microbiology 71, n.º 10 (outubro de 2005): 5920–28. http://dx.doi.org/10.1128/aem.71.10.5920-5928.2005.
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ABSTRACT Gene expression changes of glutamate-producing Corynebacterium glutamicum were identified in transcriptome comparisons by DNA microarray analysis. During glutamate production induced by a temperature shift, C. glutamicum strain 2262 showed significantly higher mRNA levels of the NCgl2816 and NCgl2817 genes than its non-glutamate-producing derivative 2262NP. Reverse transcription-PCR analysis showed that the two genes together constitute an operon. NCgl2816 putatively codes for a lactate permease, while NCgl2817 was demonstrated to encode quinone-dependent l-lactate dehydrogenase, which was named LldD. C. glutamicum LldD displayed Michaelis-Menten kinetics for the substrate l-lactate with a Km of about 0.51 mM. The specific activity of LldD was about 10-fold higher during growth on l-lactate or on an l-lactate-glucose mixture than during growth on glucose, d-lactate, or pyruvate, while the specific activity of quinone-dependent d-lactate dehydrogenase differed little with the carbon source. RNA levels of NCgl2816 and lldD were about 18-fold higher during growth on l-lactate than on pyruvate. Disruption of the NCgl2816-lldD operon resulted in loss of the ability to utilize l-lactate as the sole carbon source. Expression of lldD restored l-lactate utilization, indicating that the function of the permease gene NCgl2816 is dispensable, while LldD is essential, for growth of C. glutamicum on l-lactate.
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Romanov, Andrey Yurievich, Andrey Mikhailovich Prikhodko, Oleg Vladimirovich Tysyachnyi, Oleg Radomirovich Baev, Ekaterina Lvovna Yarotskaya e Gennady Tikhonovich Sukhikh. "Comparison of cord blood lactate measurement by gas analyzer and portable electrochemical devices". Journal of Perinatal Medicine 48, n.º 2 (25 de fevereiro de 2020): 157–61. http://dx.doi.org/10.1515/jpm-2019-0357.
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AbstractObjectiveTo compare the accuracy of cord blood lactate measurement using gas analyzer and portable devices in order to assess possibility of implementation of these devices in clinical practice.MethodsWe performed a prospective observational study using 30 umbilical cord samples which were obtained immediately after birth. Portable electrochemical devices Lactate Scout (SensLab GmbH, Leipzig, Germany) and StatStrip Lactate (NOVA Biomedical, Waltham, MA, USA) were used to determine lactate level. A gas analyzer ABL800 FLEX (Radiometer Medical ApS, Brønshøj-Husum, Denmark) was used as a reference. Base excess (BE), pH, partial oxygen (pO2) and carbon dioxide (pCO2) pressure, hemoglobin (ctHb) and bilirubin (ctBl) levels were measured.ResultsThe mean umbilical cord blood lactate level determined by the gas analyzer was 5.85 ± 2.66 mmol/L (ranging from 1.4 mmol/L to 13.4 mmol/L). Lactate level estimated by Lactate Scout was 5.66 ± 2.65 mmol/L and did not significantly differ from the reference method level (P = 0.2547). The mean lactate level determined by StatStrip Lactate was significantly lower than by the gas analyzer – 4.81 ± 2.38 mmol/L (P < 0.0001). Umbilical cord blood pH, BE, pO2 and pCO2, ctHb and ctBl levels did not affect the accuracy of the lactate measurement in absolute units (mmol/L).ConclusionUmbilical cord blood lactate level measured by StatStrip Lactate was lower than estimated by the ABL800 FLEX gas analyzer. This shows the necessity to develop decision-making reference points separately for each device. Umbilical cord blood pH, BE, pO2 and pCO2, ctHb and ctBl levels did not affect the accuracy of measurements by electrochemical portable devices.
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Wasserman, K., W. L. Beaver, J. A. Davis, J. Z. Pu, D. Heber e B. J. Whipp. "Lactate, pyruvate, and lactate-to-pyruvate ratio during exercise and recovery". Journal of Applied Physiology 59, n.º 3 (1 de setembro de 1985): 935–40. http://dx.doi.org/10.1152/jappl.1985.59.3.935.
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The pattern of lactate increase and its relation to pyruvate and lactate-to-pyruvate (L/P) ratio were studied during exercise and early recovery in 10 normal subjects for incremental exercise on a cycle ergometer. Gas exchange was measured breath by breath. Lactate and pyruvate were measured by enzymatic techniques. Lactate and log lactate changed only slightly at low levels of O2 uptake (VO2) but both began to abruptly increase at approximately 40–55% of the maximal VO2. However, the point of abrupt increase in pyruvate occurred at higher work rates and the rate of increase was not as great as that for lactate. Thus L/P ratio increased at the same VO2 as the log lactate increase. Following the exercise, pyruvate continued to increase steeply for at least the first 5 recovery min, whereas at 2 min lactate increased only slightly or decreased. Thus arterial L/P ratio reversed its direction of change and decreased toward the resting value by 2 min of recovery. Lactate, as well as L/P ratios, decreased in all subjects by 5 min. This study demonstrates that lactate and pyruvate concentrations increase slightly at low levels of exercise without a change in L/P ratio until a threshold work rate at which lactate abruptly increases without pyruvate. The resulting increase in L/P ratio is progressive as work rate is incremented and abruptly reverses when exercise stops.
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Georgi, Tobias, Verena Engels e Volker F. Wendisch. "Regulation of l-Lactate Utilization by the FadR-Type Regulator LldR of Corynebacterium glutamicum". Journal of Bacteriology 190, n.º 3 (26 de novembro de 2007): 963–71. http://dx.doi.org/10.1128/jb.01147-07.
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ABSTRACT Corynebacterium glutamicum can grow on l-lactate as a sole carbon and energy source. The NCgl2816-lldD operon encoding a putative transporter (NCgl2816) and a quinone-dependent l-lactate dehydrogenase (LldD) is required for l-lactate utilization. DNA affinity chromatography revealed that the FadR-type regulator LldR (encoded by NCgl2814) binds to the upstream region of NCgl2816-lldD. Overexpression of lldR resulted in strongly reduced NCgl2816-lldD mRNA levels and strongly reduced LldD activity, and as a consequence, a severe growth defect was observed in cells grown on l-lactate as the sole carbon and energy source, but not in cells grown on glucose, ribose, or acetate. Deletion of lldR had no effect on growth on these carbon sources but resulted in high NCgl2816-lldD mRNA levels and high LldD activity in the presence and absence of l-lactate. Purified His-tagged LldR bound to a 54-bp fragment of the NCgl2816-lldD promoter, which overlaps with the transcriptional start site determined by random amplification of cDNA ends-PCR and contains a putative operator motif typical of FadR-type regulators, which is −1TNGTNNNACNA10. Mutational analysis revealed that this motif with hyphenated dyad symmetry is essential for binding of LldD to the NCgl2816-lldD promoter. l-Lactate, but not d-lactate, interfered with binding of LldRHis to the NCgl2816-lldD promoter. Thus, during growth on media lacking l-lactate, LldR represses expression of NCgl2816-lldD. In the presence of l-lactate in the growth medium or under conditions leading to intracellular l-lactate accumulation, the l-lactate utilization operon is induced.
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Ramirez Ramos, Cristhian Felipe, Clara Inés Saldarriaga-Giraldo, Manuela Yepes-Calderón, Gustavo Adolfo Castilla-Agudelo, Mateo Aránzazu Uribe, Santiago Saldarriaga Betancur, Paulina Casto et al. "Arterial lactate levels and their prognostic value in patients undergoing pulmonary thromboendarterectomy". Archivos Peruanos de Cardiología y Cirugía Cardiovascular 2, n.º 2 (27 de maio de 2021): 123–29. http://dx.doi.org/10.47487/apcyccv.v2i2.131.
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Objective. Evaluate the change of lactate levels and its prognostic role in the postoperative period of patients undergoing pulmonary thromboendarterectomy. Methods. Retrospective study between 2001 and 2019. Patients older than 18 years and who underwent pulmonary thromboendarterectomy were included. The U Mann Whitney test was performed to evaluate the change between lactate levels, and Cox regression analysis to evaluate the relationship with mortality. Areas under the curve were constructed for lactate levels. Results. Seventy-three patients were operated on during the study period. Median age was 51 years, 55% female. The median lactate on days 1 was 4.65 mml/L and on day 2 it was 1.62 mml/L with a change of 2.87 mml/L. No differences were found between the levels measured on day 1 and 2 between the people who died and those who did not on day 30. In the multivariate regression of COX, no relationship with mortality was found. The area under the curve shows regular performance on both day 1 and day 2 in predicting mortality outcomes. Conclusions. The behavior of the lactate in patients undergoing pulmonary thromboendarterectomy shows a rapid change during the first hours after the procedure. No role was found as a predictor of mortality neither in-hospital nor in follow-up.
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Felipe, A., X. Remesar e M. Pastor-Anglada. "l-lactate uptake by rat liver. Effect of food deprivation and substrate availability". Biochemical Journal 273, n.º 1 (1 de janeiro de 1991): 195–98. http://dx.doi.org/10.1042/bj2730195.
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We have studied the role of substrate availability on net L-lactate uptake by liver of anaesthetized fed and 24 h-fasted rats. L-Lactate was infused through a mesenteric vein at infusion rates equivalent to 0, 0.125, 0.25 and 0.5 times the basal turnover rate (Rt). By these means we were able to increase L-lactate portal concentrations up to 5.5 mM, without significant changes in portal pH. In the basal state (0 Rt), a net L-lactate uptake by liver was found in 24 h-fasted animals. No net balance was observed in fed rats. Infusion of L-lactate in fed animals failed to induce a net hepatic uptake, except when L-lactate levels in portal vein were raised above 5 mM. In fasted animals, net L-lactate uptake by liver increased linearly (r = 0.99) as a function of L-lactate concentration in the portal vein, even beyond the saturation of its specific carrier. It is concluded that, first, the L-lactate carrier does not limit net L-lactate uptake, and second, that substrate availability is an important factor modulating net L-lactate uptake by liver.
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Jenei, Kinga, Ildikó Szatmári, Eszter Szabó, Anjum Mariam, Andrea Luczay, Petra Zsidegh e Péter Tóth-Heyn. "Laktátszintváltozások diabeteses ketoacidosisban és frissen diagnosztizált 1-es típusú diabetes mellitusban". Orvosi Hetilap 160, n.º 45 (novembro de 2019): 1784–90. http://dx.doi.org/10.1556/650.2019.31533.
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Abstract: Introduction: It is known that lactate concentration is increased in diabetic ketoacidosis (DKA), however, the pathophysiology and kinetics of lactate changes are still unclear. Normally, L-lactate is the major form in the human body. According to previous data, also D- and L-lactate might be increased in hyperglycaemic disorders. Aim: We aimed to describe the kinetics and mechanisms of lactate concentration changes in ketoacidosis and newly diagnosed diabetes. Method: We performed a prospective study, including 5–18-year-old children with ketoacidosis (DKA, n = 13) and with newly diagnosed type 1 diabetes without ketoacidosis (T1DM, n = 6). We performed routine blood gas analysis 0–12–24–48 hours after admission, which also measured L-lactate levels. We also determined total venous serum lactate level by gas chromatography–mass spectrometry. Results: Initial plasma lactate concentration was increased in ketoacidosis as compared to the newly diagnosed diabetes group (p<0.05). After 12 h of rehydration, lactate levels were greatly reduced in ketoacidotic patients but after 24–48 h it was repeatedly increased (all p<0.01). In the 0–12 h phase, total serum lactate level was higher than L-lactate level, referring to D-lactate production. Conclusion: We described two L-lactate peaks in ketoacidosis. In the first 12 hours anaerobic glycolysis seems to have major role in hyperlactataemia. We assume that stimulated aerobic glycolysis leads to the second lactate peak. However, D-lactate is not routinely measured, it may contribute to the initial hyperlactataemia in both groups and is comparable to L-lactate production in ketoacidosis. Orv Hetil. 2019; 160(45): 1784–1790.
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Pehnyo, N. V. "The practical significance of lactate levels in fetal blood at his urgent condition". HEALTH OF WOMAN, n.º 1(117) (28 de fevereiro de 2017): 120–22. http://dx.doi.org/10.15574/hw.2017.117.120.
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The objective: to establish whether the level of lactate in the blood of the fetus to be reliable criterion of his suffering and indication for changing tactics of childbirth. Patients and methods. The study included 511 pregnant women. Criteria for inclusion in the study: full-term births with singleton pregnancy, cephalic presentation fetus, the absence of membranes, opening the cervix 3 cm or more, according KTG questionable fetus. Included in the study are pregnant randomized into 2 groups. In the study group included 253 women in childbirth, in which the fetus at CTG rated as doubtful and determine the level of lactate in the blood taken from the skin presenting fetal head. The level of lactate measured succinct method using commercial strip test (Lactate Pro, Arkray, Kyoto, Japan). Tactics delivery determined according to the lactate levels: at <4.2 mmol / l – of delivery according to obstetric situation; 4.2-4.8 mmol / l – research again after 20 minutes; If normal level of lactate – of delivery according to obstetric situation; in the absence of normalization or improvement – prompt delivery; by level of> 4.8 mmol/l-emergency operative delivery. In the comparison group included 258 rodil with questionable condition of the fetus, which determine the level of lactate was not performed. Tactics birth in this group of patients was determined in accordance with the guidelines and regulations of Ministry of Health of Ukraine. Results. Proven method of determining the level of fetal blood lactate is technically simple to quickly get results, well tolerated, no significant complications. The level of fetal blood lactate is a sensitive marker of fetal urgent and therefore is a useful criterion for changing tactics of childbirth. As a result of proven algorithm was able to improve the newborn while reducing the frequency of operative delivery, which was 18.2% in rodil main group and 33.72% in the comparison group (p <0.01). Conclusion. 1. Determination of lactate in the blood taken from the skin of the fetal head presenting succinct method using commercial strip test (Lactate Pro, Arkray, Kyoto, Japan), to quickly obtain data on the availability of fetal acidosis. 2. The level of lactate in the blood of the fetus can serve as a diagnostic criterion of his suffering and indication for changing tactics of labor in this regard. 3. Simplicity and speed of this technique allows to recommend it for use in obstetric practice. Key words: urgent fetus, fetal blood lactate, tactics delivery.
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Merkle-Storms, Julia, Ilija Djordjevic, Carolyn Weber, Soi Avgeridou, Ihor Krasivskyi, Christopher Gaisendrees, Navid Mader et al. "Impact of Lactate Clearance on Early Outcomes in Pediatric ECMO Patients". Medicina 57, n.º 3 (18 de março de 2021): 284. http://dx.doi.org/10.3390/medicina57030284.
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Background and Objectives: Pediatric extracorporeal membrane oxygenation (ECMO) support is often the ultimate therapy for neonatal and pediatric patients with congenital heart defects after cardiac surgery. The impact of lactate clearance in pediatric patients during ECMO therapy on outcomes has been analyzed. Materials andMethods: We retrospectively analyzed data from 41 pediatric vaECMO patients between January 2006 and December 2016. Blood lactate and lactate clearance have been recorded prior to ECMO implantation and 3, 6, 9 and 12 h after ECMO start. Receiver operating characteristic (ROC) analysis was used to identify cut-off levels for lactate clearance. Results: Lactate levels prior to ECMO therapy (9.8 mmol/L vs. 13.5 mmol/L; p = 0.07) and peak lactate levels during ECMO support (10.4 mmol/L vs. 14.7 mmol/L; p = 0.07) were similar between survivors and nonsurvivors. Areas under the curve (AUC) of lactate clearance at 3, 9 h and 12 h after ECMO start were significantly predictive for mortality (p = 0.017, p = 0.049 and p = 0.006, respectively). Cut-off values of lactate clearance were 3.8%, 51% and 56%. Duration of ECMO support and respiratory ventilation was significantly longer in survivors than in nonsurvivors (p = 0.01 and p < 0.001, respectively). Conclusions: Dynamic recording of lactate clearance after ECMO start is a valuable tool to assess outcomes and effectiveness of ECMO application. Poor lactate clearance during ECMO therapy in pediatric patients is a significant marker for higher mortality.
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Doğan, NÖ, A. Savrun, S. Levent, GP Günaydın, GK Çelik, H. Akküçük e Y. Çevik. "Can initial lactate levels predict the severity of unintentional carbon monoxide poisoning?" Human & Experimental Toxicology 34, n.º 3 (27 de junho de 2014): 324–29. http://dx.doi.org/10.1177/0960327114538986.
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Introduction: Accidental carbon monoxide (CO) intoxication is a major cause of unintentional poisoning. This study aimed to determine the value of initial lactate levels in patients with CO poisoning and to evaluate its utilization in the emergency department (ED). Methods: A retrospective cross-sectional study was carried out among patients with CO intoxication, who were admitted to the ED between April 1, 2011 and April 1, 2012. The study data were extracted from a hospital database system using International Classification of Diseases-10 diagnosis codes. The patients were analyzed according to lactate levels, carboxyhemoglobin (COHb) levels, electrocardiographic manifestations, and clinical features at admission to the ED. Results: A total of 74 patients with CO poisoning were enrolled in this study. The average COHb value of the patients was 21.5 ± 13.9%. A total of 50 patients (67.6%) received normobaric oxygen treatment and 24 patients (32.4%) received hyperbaric oxygen (HBO) treatment. The patients who received HBO treatment had increased lactate levels compared with patients receiving normobaric oxygen treatment (2.3 mmol/L vs. 1.0 mmol/L, p < 0.001). The lactate levels were positively correlated with COHb values ( r = 0.738, p < 0.001). We determined that a lactate level of 1.85 mmol/L has a sensitivity of 70.8% and a specificity of 78.0% to predict the HBO treatment needed in CO poisoning. Conclusion: In evaluating patients with CO poisoning, an initial lactate level could be taken into consideration as an adjunctive parameter of severity, together with the clinical criteria and levels of COHb.
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Rana, Faraz Ali, Helen Mary Robert, Madiha Ilyas, Asad Mahmood, Muhammad Amir e Nabeela Khan. "DIAGNOSTIC UTILITY OF SERUM LACTATE DEHYDROGENASE LEVELS (LDL) IN DIFFERENTIATING MEGALOBLASTIC ANEMIA FROM MYELODYSPLASTIC SYNDROMES IN PAKISTAN". PAFMJ 71, n.º 5 (30 de outubro de 2021): 1539–43. http://dx.doi.org/10.51253/pafmj.v71i5.5003.
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Objective: To study the diagnostic utility of lactate dehydrogenase levels in differentiating megaloblastic anemia from myelodysplastic anemia in Pakistan.
Study Design: Comparative cross-sectional study.
Place and Duration of Study: Department of Hematology, Armed Forces Institute of Pathology, Rawalpindi, Pakistan from Feb, 2019 to Aug, 2019.
Methodology: In this study, total 240 patients (18-75 years of age) males and females were selected by consecutive sampling technique and were equally divided into 3 groups; patients with megaloblastic anemia, patients with myelodysplastic syndromes and healthy control group. The clinical history and duration of anemia were recorded on special designed proforma. The laboratory investigations including lactate dehydrogenase levels were also noted. Both types of anemia were compared on basis of Lactate Dehydrogenase Levels.
Results: The lactate dehydrogenase levels in megaloblastic group were more than 3000 IU/L in 58 out of 80 patients (72.5%). On other hand, myelodysplastic group had 79 out of 80 patients with lactic acid dehydrogenase levels below 450 IU/L (98.75%). The difference in lactic acid dehydrogenase levels between both groups was found to be statistically significant.
Conclusion: Serum lactate dehydrogenase levels can be used to differentiate megaloblastic anemia from other anemia especially myelodysplastic syndromes before doing a bone marrow examination. High lactate dehydrogenase levels above 3000 IU/L in megaloblastic anemia can differentiate it from other anemia.
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Mosienko, Valentina, Anja G. Teschemacher e Sergey Kasparov. "Is L-Lactate a Novel Signaling Molecule in the Brain?" Journal of Cerebral Blood Flow & Metabolism 35, n.º 7 (29 de abril de 2015): 1069–75. http://dx.doi.org/10.1038/jcbfm.2015.77.
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In the brain, L-lactate is produced by both neurons and astrocytes. There is no doubt that neurons use L-lactate as a supplementary fuel although the importance of this energy source is disputed. Irrespective of its caloric value, L-lactate might also have a signaling role in the brain. Here, we review several current hypotheses of L-lactate mediated signaling. Some proposed mechanisms require L-lactate entry into the neurons leading to a shift in ATP/ADP ratio or redox state. Others postulate interaction with either known receptor HCA1 (GPR81) or a novel, yet unidentified receptor. We argue that the sensitivity of any such mechanism has to match the concentration range of extracellular L-lactate, which is less than ~ 1.5 mmol/L under physiologic conditions. From that point of view, some of the proposed mechanisms require supraphysiologic levels of L-lactate and could be engaged during ischemia or seizures when L-lactate concentration rises dramatically. Currently, we do not know whether L-lactate production in the brain occurs in microdomains, which might create higher than average local concentrations. Nevertheless, it is clear that in the brain, as in the peripheral tissues, L-lactate is not only used as a source of energy but also acts as a signaling molecule.
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Santos, Renato X., Valeria Melis, Elizabeth A. Goatman, Michael Leith, Thomas C. Baddeley, John M. D. Storey, Gernot Riedel, Claude M. Wischik e Charles R. Harrington. "HMTM-Mediated Enhancement of Brain Bioenergetics in a Mouse Tauopathy Model Is Blocked by Chronic Administration of Rivastigmine". Biomedicines 10, n.º 4 (7 de abril de 2022): 867. http://dx.doi.org/10.3390/biomedicines10040867.
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The tau protein aggregation inhibitor hydromethylthionine mesylate (HMTM) was shown recently to have concentration-dependent pharmacological activity in delaying cognitive decline and brain atrophy in phase 3 Alzheimer’s disease (AD) clinical trials; the activity was reduced in patients receiving symptomatic therapies. The methylthionine (MT) moiety has been reported to increase the clearance of pathological tau and to enhance mitochondrial activity, which is impaired in AD patients. In line 1 (L1) mice (a model of AD), HMTM (5/15 mg/kg) was administered either as a monotherapy or as an add-on to a chronic administration with the cholinesterase inhibitor rivastigmine (0.1/0.5 mg/kg) to explore mitochondrial function and energy substrate utilization as potential targets of drug interference. Compared with wild-type NMRI mice, the L1 mice accumulated greater levels of l-lactate and of the LDH-A subunit responsible for the conversion of pyruvate into l-lactate. In contrast, the levels of LDH-B and mitochondrial ETC subunits and the activity of complexes I and IV was not altered in the L1 mice. The activity of complex I and complex IV tended to increase with the HMTM dosing, in turn decreasing l-lactate accumulation in the brains of the L1 mice, despite increasing the levels of LDH-A. The chronic pre-dosing of the L1 mice with rivastigmine partially prevented the enhancement of the activity of complexes I and IV by HMTM and the increase in the levels of LDH-A while further reducing the levels of l-lactate. Thus, HMTM in combination with rivastigmine leads to a depletion in the energy substrate l-lactate, despite bioenergetic production not being favoured. In this study, the changes in l-lactate appear to be regulated by LDH-A, since neither of the experimental conditions affected the levels of LDH-B. The data show that HMTM monotherapy facilitates the use of substrates for energy production, particularly l-lactate, which is provided by astrocytes, additionally demonstrating that a chronic pre-treatment with rivastigmine prevented most of the HMTM-associated effects.
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Severson, Kristen A., Laura Ritter-Cox, Jesse D. Raffa, Leo Anthony Celi e William J. Gordon. "Vasopressin Administration Is Associated With Rising Serum Lactate Levels in Patients With Sepsis". Journal of Intensive Care Medicine 35, n.º 9 (21 de agosto de 2018): 881–88. http://dx.doi.org/10.1177/0885066618794925.
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Background:Vasopressin is used in conjunction with norepinephrine during treatment of patients with septic shock. Serum lactate is often used in monitoring of patients with sepsis; however, its importance as a therapeutic target is unclear. The objective of this study is to examine the relationship of vasopressin use on serum lactate levels in patients with sepsis.Methods:This study uses electronic heath records available via the Medical Information Mart for Intensive Care III. Patients were required to have a serum lactate monitoring during the intensive care unit (ICU) stay. The treatment was the administration of vasopressin between hours 3 and 18 of the ICU stay. Analysis was performed using a matched design.Results:Patients receiving vasopressin were more likely to have their serum lactate levels rise when compared to matched patients who did not receive vasopressin (odds ratio: 6.6; 95% confidence interval: 3.0-14.6, P < .001). Patients who received vasopressin had a median increase in serum lactate of 0.3 mmol/L, while patients who did not receive vasopressin had a median decrease in serum lactate of 0.7 mmol/L ( P < .001). There was no statistically significant difference between the control and treated groups’ lactate trajectories prior to possible administration of vasopressin ( P = .15). The results did not change significantly when norepinephrine initiation was used as the index time.Conclusions:In patients with sepsis, the administration of vasopressin was associated with a statistically significant difference in lactate change over the course of 24 hours when compared to matched patients who did not receive vasopressin.
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Stevenson, R. W., D. R. Mitchell, G. K. Hendrick, R. Rainey, A. D. Cherrington e R. T. Frizzell. "Lactate as substrate for glycogen resynthesis after exercise". Journal of Applied Physiology 62, n.º 6 (1 de junho de 1987): 2237–40. http://dx.doi.org/10.1152/jappl.1987.62.6.2237.
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Muscle glycogen levels in the perfused rat hemicorpus preparation were reduced two-thirds by electrical stimulation plus exposure to epinephrine (10(-7) M) for 30 min. During the contraction period muscle lactate concentrations increased from a control level of 3.6 +/- 0.6 to a final value of 24.1 +/- 1.6 mumol/g muscle. To determine whether the lactate that had accumulated in muscle during contraction could be used to resynthesize glycogen, glycogen levels were determined after 1–3 h of recovery from the contraction period during which time the perfusion medium (flow-through system) contained low (1.3 mmol/l) or high (10.5 or 18 mmol/l) lactate concentrations but no glucose. With the low perfusate lactate concentration, muscle lactate levels declined to 7.2 +/- 0.8 mumol/g muscle by 3 h after the contraction period and muscle glycogen levels did not increase (1.28 +/- 0.07 at 3 h vs. 1.35 +/- 0.09 mg glucosyl U/g at end of exercise). Lactate disappearance from muscle was accounted for entirely by output into the venous effluent. With the high perfusate lactate concentrations, muscle lactate levels remained high (13.7 +/- 1.7 and 19.3 +/- 2.0 mumol/g) and glycogen levels increased by 1.11 and 0.86 mg glucosyl U/g, respectively, after 1 h of recovery from exercise. No more glycogen was synthesized when the recovery period was extended. Therefore, it appears that limited resynthesis of glycogen from lactate can occur after the contraction period but only when arterial lactate concentrations are high; otherwise the lactate that builds up in muscle during contraction will diffuse into the bloodstream.
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Veličković, Jelena, Ivan Palibrk, Biljana Miličić, Dejan Veličković, Bojan Jovanović, Goran Rakić, Milorad Petrović e Vesna Bumbaširević. "The association of early postoperative lactate levels with morbidity after elective major abdominal surgery". Bosnian Journal of Basic Medical Sciences 19, n.º 1 (12 de fevereiro de 2019): 72–80. http://dx.doi.org/10.17305/bjbms.2018.3186.
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Lactate levels are widely used as an indicator of outcome in critically ill patients. We investigated the prognostic value of postoperative lactate levels for postoperative complications (POCs), mortality and length of hospital stay after elective major abdominal surgery. A total of 195 patients were prospectively evaluated. Lactate levels were assessed on admission to the intensive care unit (ICU) [L0], at 4 hours (L4), 12 hours (L12), and 24 hours (L24) after the operation. Demographic and perioperative clinical data were collected. Patients were monitored for complications until discharge or death. Receiver operating characteristic (ROC) curves were used to determine the predictive value of lactate levels for postoperative outcomes. The best cut-off lactate values were calculated to differentiate between patients with and without complications, and outcomes in patients with lactate levels above and below the cut-off thresholds were compared. Univariate and multivariate analyses were used to identify variables associated with POCs and mortality. Seventy-six patients developed 184 complications (18 deaths), while 119 had no complications. Serum lactate levels were higher in patients with complications at all time points compared to those without complications (p < 0.001). L12 had the highest predictive value for complications (AUROC12 = 0.787; 95% CI: 0.719–0.854; p < 0.001) and mortality (AUROC12 = 0.872; 95% CI: 0.794–0.950; p < 0.001). The best L12 cut-off value for complications and mortality was 1.35 mmol/l and 1.85 mmol/l, respectively. Multivariate analysis revealed that L12 ≥ 1.35 mmol/l was an independent predictor of postoperative morbidity (OR 2.58; 95% CI 1.27–5.24, p = 0.001). L24 was predictive of POCs after major abdominal surgery. L12 had the best power to discriminate between patients with and without POCs and was associated with a longer hospital stay.
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Chen, Fu-Cheng, Chia-Te Kung, Hsien-Hung Cheng, Chi-Yung Cheng, Tsung-Cheng Tsai, Sheng-Yuan Hsiao, Chien-Hung Wu e Chih-Min Su. "Metformin Affects Serum Lactate Levels in Predicting Mortality of Patients with Sepsis and Bacteremia". Journal of Clinical Medicine 8, n.º 3 (6 de março de 2019): 318. http://dx.doi.org/10.3390/jcm8030318.
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This study determined if the use of metformin affected the prognostic value of hyperlactatemia in predicting 28-day mortality among patients with sepsis and bacteremia. We enrolled adult diabetic patients with sepsis and bacteremia. Of 590 patients, 162 and 162 metformin users and nonusers, respectively, were selected in propensity matching. The mean serum lactate levels in metformin users were higher than those in nonusers (4.7 vs. 3.9 mmol/L, p = 0.044). We divided the patients into four groups based on quick Sepsis-related Organ Failure Assessment (qSOFA) scores. No significant difference was found among nonusers with qSOFA score <2, nonusers with qSOFA score ≥2, and metformin users with qSOFA score <2. The lactate levels in metformin users with qSOFA score ≥2 were higher than those in other groups, and significant differences were found in both nonsurvivors (8.9 vs. 4.6 mmol/L, p = 0.027) and survivors (6.4 vs. 3.8 mmol/L, p = 0.049) compared with metformin users with qSOFA score <2. The best cut-off point to predict 28-day mortality in metformin users (5.9 mmol/L; area under the receiver operating characteristic curve (AUROC), 0.66; 95% confidence interval (CI), 0.55–0.77) was higher than that in nonusers (3.6 mmol/L; AUROC 0.63; 95% CI, 0.56–0.70). Metformin users had higher lactate levels than nonusers in increasing sepsis severity. Serum lactate levels could be useful in predicting mortality in patients using metformin, but higher levels are required to obtain more precise results.
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Jon Van Tienhoven, Arne, Cornelis AJ Van Beers, Carl EH Siegert e Prabath WB Nanayakkara. "The utility of peripheral venous lactate in emergency department patients with normal and higher lactate levels: A prospective observational study". Acute Medicine Journal 19, n.º 3 (1 de julho de 2020): 125–30. http://dx.doi.org/10.52964/amja.0815.
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Objective: to assess the utility of peripheral venous lactate (PVL) in Emergency Department patients. Methods: arteriovenous agreement was assessed in three subgroups: PVL <2 mmol/l, PVL ≥ 2 mmol/l to < 4 mmol/l and PVL ≥ 4 mmol/l. The predictive value of PVL to predict arterial lactate (AL) ≥2 mmol/l was assessed at different cut-off values. Results: 74 samples were analysed. The venous-arterial mean difference and 95% limits of agreement for the subgroups were 0.25 mmol/l (-0.18 to 0.68), 0.37 mmol/l (-0.57 to 1.32) and -0.89 mmol/l (-3.75 to 1.97). PVL ≥2 mmol/l predicts AL ≥2 mmol/l with 100% sensitivity. Conclusion: PVL <2 mmol/l rules out arterial hyperlactatemia. As agreement declines in higher levels, arterial sampling should be considered.
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Xu, Xianzhi, Rong Xu, Shuang Hou, Zhaoqi Kang, Chuanjuan Lü, Qian Wang, Wen Zhang et al. "A Selective Fluorescent l-Lactate Biosensor Based on an l-Lactate-Specific Transcription Regulator and Förster Resonance Energy Transfer". Biosensors 12, n.º 12 (1 de dezembro de 2022): 1111. http://dx.doi.org/10.3390/bios12121111.
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Selective detection of l-lactate levels in foods, clinical, and bacterial fermentation samples has drawn intensive attention. Many fluorescent biosensors based on non-stereoselective recognition elements have been developed for lactate detection. Herein, the allosteric transcription factor STLldR from Salmonella enterica serovar Typhimurium LT2 was identified to be stereo-selectively respond to l-lactate. Then, STLldR was combined with Förster resonance energy transfer (FRET) to construct a fluorescent l-lactate biosensor FILLac. FILLac was further optimized by truncating the N- and C-terminal amino acids of STLldR between cyan and yellow fluorescent proteins. The optimized biosensor FILLac10N0C exhibited a maximum emission ratio change (ΔRmax) of 33.47 ± 1.91%, an apparent dissociation constant (Kd) of 6.33 ± 0.79 μM, and a limit of detection of 0.68 μM. FILLac10N0C was applied in 96-well microplates to detect l-lactate in bacterial fermentation samples and commercial foods such as Jiaosu and yogurt. The quantitation results of FILLac10N0C exhibited good agreement with that of a commercial l-lactate biosensor SBA-40D bioanalyzer. Thus, the biosensor FILLac10N0C compatible with high-throughput detection may be a potential choice for quantitation of l-lactate in different biological samples.
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Cooker, Laurinda A., Patricia Luneburg, Clifford J. Holmes, Suzanne Jones, Nicholas Topley, D. O'Donoghue, L. Frenken et al. "Interleukin-6 Levels Decrease in Effluent from Patients Dialyzed with Bicarbonate/Lactate–Based Peritoneal Dialysis Solutions". Peritoneal Dialysis International: Journal of the International Society for Peritoneal Dialysis 21, n.º 3_suppl (dezembro de 2001): 102–7. http://dx.doi.org/10.1177/089686080102103s17.
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♦ Objective Conventional lactate-buffered peritoneal dialysis (PD) solutions have several bioincompatible characteristics, including acidic pH, lactate buffer, and the presence of glucose degradation products (GDPs). These characteristics, along with inflammation, are believed to contribute to membrane dysfunction in peritoneal dialysis patients. A new PD solution containing a bicarbonate/ lactate buffer system with physiologic pH and low GDPs has shown improved biocompatibility in both in vitro and ex vivo studies. In the present study, the concentrations of cytokines interleukin-6 (IL-6), tumor necrosis factor alpha (TNFα), and vascular endothelial growth factor (VEGF), were measured in timed overnight effluents from PD patients continuously dialyzed with either lactate-based control solution (C) or bicarbonate/lactate–based solution (B/L) for 6 months. ♦ Methods Effluents from 92 continuous ambulatory peritoneal dialysis (CAPD) patients were collected when the patients were entered into the study (baseline, all patients on C for more than 3 months), and at 3 and 6 months following randomization to C ( n = 31) or to B/L ( n = 61). Effluent samples were filtered, stored frozen, and then assayed for IL-6, TNFα, and VEGF by ELISA. ♦ Results A significant decrease in effluent IL-6 was seen at 3 months and at 6 months in the B/L-treated patients. Levels of VEGF were significantly reduced at 3 months. No changes in the levels of IL-6 or VEGF were seen in the C-treated patients, and no changes in TNFα were seen in either group over time. ♦ Conclusions Treatment with B/L is associated with decreased IL-6 synthesis and decreased VEGF secretion. The data suggest that the use of B/L solution is associated with reduced intraperitoneal inflammation and potential for angiogenesis. The use of B/L solution may, over time, help to restore peritoneal homeostasis and therefore preserve the function of the membrane in peritoneal dialysis.
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Otte, Kjeld, Maria Theresa Gonzalez, Maria-Auxiliadora Bajo, Gloria Del Peso, James Heaf, Gorka Garcia Erauzkin, Jose A. Sanchez Tomero et al. "Clinical Experience with a New Bicarbonate (25 Mmol/L)/Lactate (10 Mmol/L) Peritoneal Dialysis Solution". Peritoneal Dialysis International: Journal of the International Society for Peritoneal Dialysis 23, n.º 2 (março de 2003): 138–45. http://dx.doi.org/10.1177/089686080302300208.
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Objective Physiological bicarbonate/lactate-based solutions may correct acidosis in a better way than standard lactate-based solutions. In this study, a new 25 mmol/L bicarbonate/10 mmol/L lactate peritoneal dialysis (PD) solution was compared with a standard 35 mmol/L lactate solution. Design This was a prospective open label study. All patients had a 2-week baseline period using the standard lactate solution, followed by 8 weeks on the bicarbonate/lactate solution and 2 weeks on the lactate-basedsolution. Setting Four Danish and four Spanish nephrology centers. Patients 40 well-dialyzed (creatinine clearance > 55 L/week/1.73 m2 body surface area) patients on continuous ambulatory PD. Interventions Blood samples were taken for biochemistry (including venous blood gases) at week –2, day 1, weeks 2, 4, and 8, and at follow-up. A physical examination, a peritoneal equilibration test (PET), and quality of life (K/DQOL), ultrafiltration, and adequacy assessments were performed at baseline and at week 8. Vital signs and other safety parameters were followed at each visit. Extraneal (Baxter Healthcare, Castlebar, Ireland) was used by all patients for the long dwell. Main Outcome Measure Effect on the venous plasma bicarbonate level. Results Venous plasma bicarbonate levels rose from 24.4 mmol/L when patients were on the pure lactate to 26.1 mmol/L when using the bicarbonate/lactate solution ( p < 0.001). When patients were using the bicarbonate/lactate solution, 66% of values were maintained within the venous normal range of 24 – 30 mmol/L, versus 46.2% when patients were on the pure lactate solution ( p < 0.001). There were no adverse findings with respect to clinical symptoms, vital signs, or physical examination. The PET and adequacy, ultrafiltration, and K/DQOL assessment results were unchanged. Conclusions The new 25 mmol/L bicarbonate/10 mmol/L lactate solution provided better correction of acidosis than an equivalent 35 mmol/L standard lactate solution, without any safety issues.
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Iskandar, Agustin, Nada Putri Pranidya, Eko Sulistijono e Aryati Aryati. "Correlation Between Lactic Acid Concentration and The Severity of Neonatal Sepsis". INDONESIAN JOURNAL OF CLINICAL PATHOLOGY AND MEDICAL LABORATORY 26, n.º 1 (22 de novembro de 2019): 55. http://dx.doi.org/10.24293/ijcpml.v26i1.1370.
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BackgroundsNeonatal sepsis remains a major cause of high infant mortality rate in Indonesia, and served as one of risk factor for early neonatal mortality. This study aims to determine the relationship between lactate levels andthe severity of sepsis and prognostic value of lactic acid as a predictor of severity in neonatal sepsis.. MethodsThis research is analytic observational research using cross sectional method. The subjects were patients of neonatal sepsis treated in the Perinatology Room of Saiful Anwar Hospital Malang from February to June 2015. Lactic acid concentration in plasma was measured by using enzymatic colorimetric methodResults and DiscussionThe results showed a positive and significant correlation (p = 0,023; r= o,414) between lactate concentration and severity of sepsis, where every increase of sepsis degree increased lactate level of 0,151 mmol / L. Whereas by using cut off ≥ 2.5 mmol / L, the prognostic test showed 66.7% of sensitivity and 76.2% of specificity. The chi square test of lactate> 2 mmol / L and <2 mmol / L showed Odd Ratio (OR) of 1,3 whereas at lactate level > 5 mmol / L and <5 mmol / L showed OR of 4,8 indicated that although there was no difference but the mortality outcomes of neonatal sepsis 4.8 times greater those of life. Thus lactate levelsof > 5 mmol / L can determine mortality outcome of neonatal sepsis.Conclusions and suggestionsThe higher the lactic acid level the more severe of neonatal sepsis. Lactate levels greater than 5 mmol / L was predictor for determining mortality outcome in neonatal sepsis
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Charlton, Karl, e Hayley Stagg. "Prognostic value of lactate in out-of-hospital cardiac arrest: a prospective cohort study". Journal of Paramedic Practice 14, n.º 4 (2 de abril de 2022): 138–45. http://dx.doi.org/10.12968/jpar.2022.14.4.138.
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Background: The prognostic role of lactate in out-of-hospital cardiac arrest (OHCA) remains unclear. Aims: To explore serum lactate as a predictor of return of spontaneous circulation in patients experiencing OHCA after arrival at hospital. Methods: This 13-month prospective observational cohort study involved patients aged ≥18 years. Serum lactate levels were measured during cardiopulmonary resuscitation before ROSC. Patients were divided into two groups by lactate level: Group 1, low (≤9.9 mmol/l) and Group 2, high (≥10 mmol/l). Findings: 105 patients were included, 50 in group 1 and 55 group 2. Median lactate were 7.4 mmol/l and 14.2 mmol/l respectively. More patients in group 1 were found with ventricular fibrillation (40% versus 14.5%; P≤0.01), obtained ROSC more quickly (37 minutes 38 seconds versus 39 minutes 13 seconds; P=0.79) and achieved short-term survival (survived >24 hours) (40% versus 23.5%; P=0.32), versus group 2; prediction of survival did not reach statistical significance. Conclusion: Lower lactate levels in OHCA appear to be associated with better short-term outcomes but the cut-off points regarding survival remain unclear.
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Hsu, Shu-Hsien, Po-Hsuan Kao, Tsung-Chien Lu, Chih-Hung Wang, Cheng-Chung Fang, Wei-Tien Chang, Chien-Hua Huang e Chu-Lin Tsai. "Serum Lactate for Predicting Cardiac Arrest in the Emergency Department". Journal of Clinical Medicine 11, n.º 2 (13 de janeiro de 2022): 403. http://dx.doi.org/10.3390/jcm11020403.
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Objectives: Early recognition and prevention of in-hospital cardiac arrest (IHCA) play an increasingly important role in the Chain of Survival. However, clinical tools for predicting IHCA in the emergency department (ED) are scanty. We sought to evaluate the role of serum lactate in predicting ED-based IHCA. Methods: Data were retrieved from 733,398 ED visits over a 7-year period in a tertiary medical centre. We selected one ED visit per person and excluded out-of-hospital cardiac arrest, children, or those without lactate measurements. Patient demographics, computerised triage information, and serum lactate levels were extracted. The initial serum lactate levels were grouped into normal (≤2 mmol/L), moderately elevated (2 < lactate ≤ 4), and highly elevated (>4 mmol/L) categories. The primary outcome was ED-based IHCA. Results: A total of 17,392 adult patients were included. Of them, 342 (2%) developed IHCA. About 50% of the lactate levels were normal, 30% were moderately elevated, and 20% were highly elevated. In multivariable analysis, the group with highly elevated lactate had an 18-fold increased risk of IHCA (adjusted odds ratio [OR], 18.0; 95% confidence interval [CI], 11.5–28.2), compared with the normal lactate group. In subgroup analysis, the poor lactate-clearance group (<2.5%/h) was associated with a 7.5-fold higher risk of IHCA (adjusted OR, 7.5; 95%CI, 3.7–15.1) compared with the normal clearance group. Conclusions: Elevated lactate levels and poor lactate clearance were strongly associated with a higher risk of ED-based IHCA. Clinicians may consider a more liberal sampling of lactate in patients at higher risk of IHCA with follow-up of abnormal levels.
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Mazza, Juan C., Raúl L. Festa, Sandra L. Prieto, Patricia Cosolito e Alvaro N. Gurovich. "Lactate Threshold Velocity At 4 mMol/l Does Not Maintain Blood Lactate Levels During Steady State Intensity". Medicine & Science in Sports & Exercise 51, Supplement (junho de 2019): 325. http://dx.doi.org/10.1249/01.mss.0000561484.04890.33.
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Park, Ik Hyun, Hyun Kyu Cho, Ju Hyeon Oh, Woo Jung Chun, Yong Hwan Park, Mirae Lee, Min Sun Kim et al. "Clinical Significance of Serum Lactate in Acute Myocardial Infarction: A Cardiac Magnetic Resonance Imaging Study". Journal of Clinical Medicine 10, n.º 22 (13 de novembro de 2021): 5278. http://dx.doi.org/10.3390/jcm10225278.
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Little is known about causality and the pathological mechanism underlying the association of serum lactate with myocardial injury in patients with acute myocardial infarction (AMI). We evaluated data from 360 AMI patients undergoing percutaneous coronary intervention (PCI) using cardiovascular magnetic resonance imaging (CMR). Of these, 119 patients had serum lactate levels > 2.5 mmol/L on admission (high serum lactate group), whereas 241 patients had serum lactate levels ≤ 2.5 mmol/L (low serum lactate group). We compared the myocardial infarct size assessed by CMR between the two groups and performed inverse probability of treatment weighting (IPTW). In CMR analysis, myocardial infarct size was significantly greater in the high serum lactate group than in the low serum lactate group (22.0 ± 11.4% in the high serum lactate group vs. 18.9 ± 10.5% in the low serum lactate group; p = 0.011). The result was consistent after IPTW adjustment (21.5 ± 11.1% vs. 19.2 ± 10.4%; p = 0.044). In multivariate analysis, high serum lactate was associated with larger myocardial infarct (odds ratio 1.59; 95% confidence interval 1.00–2.51; p = 0.048). High serum lactate could predict advanced myocardial injury in AMI patients undergoing PCI.
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Pan, Jullie W., Douglas L. Rothman, Kevin L. Behar, Daniel T. Stein e Hoby P. Hetherington. "Human Brain β-Hydroxybutyrate and Lactate Increase in Fasting-Induced Ketosis". Journal of Cerebral Blood Flow & Metabolism 20, n.º 10 (outubro de 2000): 1502–7. http://dx.doi.org/10.1097/00004647-200010000-00012.
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Ketones are known to constitute an important fraction of fuel for consumption by the brain, with brain ketone content generally thought to be low. However, the recent observation of 1-mmol/L levels of brain β-hydroxybutyrate (BHB) in children on the ketogenic diet suggests otherwise. The authors report the measurement of brain BHB and lactate in the occipital lobe of healthy adults using high field (4-T) magnetic resonance spectroscopy, measured in the nonfasted state and after 2-and 3-day fasting-induced ketosis. A 9-mL voxel located in the calcarine fissure was studied, detecting the BHB and lactate upfield resonances using a 1H homonuclear editing sequence. Plasma BHB levels also were measured. The mean brain BHB concentration increased from a nonfasted level of 0.05 ± 0.05 to 0.60 ± 0.26 mmol/L (after second day of fasting), increasing further to 0.98 ± 0.16 mmol/L (after the third day of fasting). The mean nonfasted brain lactate was 0.69 ± 0.17 mmol/L, increasing to 1.47 ± 0.22 mmol/L after the third day. The plasma and brain BHB levels correlated well ( r = 0.86) with a brain–plasma slope of 0.26. These data show that brain BHB rises significantly with 2-and 3-day fasting-induced ketosis. The lactate increase likely results from ketones displacing lactate oxidation without altering glucose phosphorylation and glycolysis.
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Carrard, A., M. Elsayed, M. Margineanu, B. Boury-Jamot, L. Fragnière, E. M. Meylan, J.-M. Petit, H. Fiumelli, P. J. Magistretti e J.-L. Martin. "Peripheral administration of lactate produces antidepressant-like effects". Molecular Psychiatry 23, n.º 2 (18 de outubro de 2016): 392–99. http://dx.doi.org/10.1038/mp.2016.179.
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Abstract In addition to its role as metabolic substrate that can sustain neuronal function and viability, emerging evidence supports a role for l-lactate as an intercellular signaling molecule involved in synaptic plasticity. Clinical and basic research studies have shown that major depression and chronic stress are associated with alterations in structural and functional plasticity. These findings led us to investigate the role of l-lactate as a potential novel antidepressant. Here we show that peripheral administration of l-lactate produces antidepressant-like effects in different animal models of depression that respond to acute and chronic antidepressant treatment. The antidepressant-like effects of l-lactate are associated with increases in hippocampal lactate levels and with changes in the expression of target genes involved in serotonin receptor trafficking, astrocyte functions, neurogenesis, nitric oxide synthesis and cAMP signaling. Further elucidation of the mechanisms underlying the antidepressant effects of l-lactate may help to identify novel therapeutic targets for the treatment of depression.
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Morris, David M., Rebecca S. Shafer, Kimberly R. Fairbrother e Mark W. Woodall. "Effects of Lactate Consumption on Blood Bicarbonate Levels and Performance During High-Intensity Exercise". International Journal of Sport Nutrition and Exercise Metabolism 21, n.º 4 (agosto de 2011): 311–17. http://dx.doi.org/10.1123/ijsnem.21.4.311.
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The authors sought to determine the effects of oral lactate consumption on blood bicarbonate (HCO3−) levels, pH levels, and performance during high-intensity exercise on a cycle ergometer. Subjects (N = 11) were trained male and female cyclists. Time to exhaustion (TTE) and total work were measured during high-intensity exercise bouts 80 min after the consumption of 120 mg/kg body mass of lactate (L), an equal volume of placebo (PL), or no treatment (NT). Blood HCO3− increased significantly after ingestion of lactate (p < .05) but was not affected in PL or NT (p > .05). No changes in pH were observed as a result of treatment. TTE and total work during the performance test increased significantly by 17% in L compared with PL and NT (p = .02). No significant differences in TTE and total work were seen between the PL and NT protocols (p = .85). The authors conclude that consuming 120 mg/kg body mass of lactate increases HCO3− levels and increases exercise performance during high-intensity cycling ergometry to exhaustion.
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Wiegers, Evita C., Hanne M. Rooijackers, Cees J. Tack, Bart WJ Philips, Arend Heerschap, Marinette van der Graaf e Bastiaan E. de Galan. "Effect of lactate administration on brain lactate levels during hypoglycemia in patients with type 1 diabetes". Journal of Cerebral Blood Flow & Metabolism 39, n.º 10 (11 de maio de 2018): 1974–82. http://dx.doi.org/10.1177/0271678x18775884.
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Administration of lactate during hypoglycemia suppresses symptoms and counterregulatory responses, as seen in patients with type 1 diabetes and impaired awareness of hypoglycemia (IAH), presumably because lactate can substitute for glucose as a brain fuel. Here, we examined whether lactate administration, in a dose sufficient to impair awareness of hypoglycemia, affects brain lactate levels in patients with normal awareness of hypoglycemia (NAH). Patients with NAH ( n = 6) underwent two euglycemic-hypoglycemic clamps (2.8 mmol/L), once with sodium lactate infusion (NAH w|lac) and once with saline infusion (NAH w|placebo). Results were compared to those obtained during lactate administration in patients with IAH ( n = 7) (IAH w|lac). Brain lactate levels were determined continuously with J-difference editing 1H-MRS. During lactate infusion, symptom and adrenaline responses to hypoglycemia were considerably suppressed in NAH. Infusion of lactate increased brain lactate levels modestly, but comparably, in both groups (mean increase in NAH w|lac: 0.12 ± 0.05 µmol/g and in IAH w|lac: 0.06 ± 0.04 µmol/g). The modest increase in brain lactate may suggest that the excess of lactate is immediately metabolized by the brain, which in turn may explain the suppressive effects of lactate on awareness of hypoglycemia observed in patients with NAH.
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Andrews, M. A., R. E. Godt e T. M. Nosek. "Influence of physiological L(+)-lactate concentrations on contractility of skinned striated muscle fibers of rabbit". Journal of Applied Physiology 80, n.º 6 (1 de junho de 1996): 2060–65. http://dx.doi.org/10.1152/jappl.1996.80.6.2060.
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These experiments investigated the effects of physiological concentrations of L(+)-lactate on the contractility of chemically skinned rabbit fast-twitch psoas, slow-twitch soleus, and cardiac muscles at pH 7.L(+)-Lactate depressed maximal calcium-activated force (Fmax) of all muscles studied within the range of 5-20 (slow-twitch muscle) or 5-25 mM (fast-twitch and cardiac muscles). Fmax of fast-twitch fibers was inhibited to the greatest degree (9% in K2 creatine phosphate solutions). In all of these muscle types, Fmax returned to control levels as L(+)-lactate was increased to 30-50 mM. Substitution of neither D-lactate nor propionate for L(+)-lactate significantly altered Fmax. In addition, with the exception of fast-twitch muscle (where the Hill coefficient decreased), L(+)-lactate concentrations, which maximally inhibited Fmax, did not affect the force vs. pCa relationship of muscles tested. These results demonstrate that L(+)-lactate significantly contributes to the depression of muscle function noted during lactic acidosis, directly inhibiting Fmax of the contractile apparatus. This contribution is maximal in fast-twitch muscle where L(+)-lactate is responsible for as much as one-third of the depressant effect on Fmax of the contractile apparatus noted during lactic acidosis.
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Chen, Xue, Jianbin Bi, Jia Zhang, Zhaoqing Du, Yifan Ren, Shasha Wei, Fenggang Ren, Zheng Wu, Yi Lv e Rongqian Wu. "The Impact of Serum Glucose on the Predictive Value of Serum Lactate for Hospital Mortality in Critically Ill Surgical Patients". Disease Markers 2019 (26 de novembro de 2019): 1–10. http://dx.doi.org/10.1155/2019/1578502.
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Background. Lactate has been widely used as a risk indicator of outcomes in critically ill patients due to its ready measurement and good predictive ability. However, the interconnections between lactate metabolism and glucose metabolism have not been sufficiently explored, yet. In this study, we aimed to investigate whether glucose levels could influence the predictive ability of lactate and design a more comprehensive strategy to assess the in-hospital mortality of critically ill patients. Methods. We analyzed the clinical data of 293 critically ill patients. The primary outcome was in-hospital mortality. The logistic regression analysis and the area under the receiver operating characteristic curve (AUROC) were applied to evaluate the predictive ability of lactate in association with glucose. Results. The lactate level showed significant association with in-hospital mortality, and its predictive ability was also comparable to other prognostic scores such as the SOFA score and APACHE II score. We further divided 293 patients into three groups based on glucose levels: low-glucose group (<7 mmol/L), medium-glucose group (7-9 mmol/L), and high-glucose group (>9 mmol/L). The lactate level was associated with in-hospital mortality in the low- and high- glucose groups, but not in the medium-glucose group, whereas the SOFA score and APACHE II score were associated with in-hospital mortality in all three glucose groups. The AUROC of lactate in the medium-glucose group was also the lowest among the three glucose groups, indicating a decrease in its predictive ability. Conclusions. Our findings demonstrated that the predictive ability of lactate to assess in-hospital mortality could be influenced by glucose levels. In the medium glucose level (i.e., 7-9 mmol/L), lactate was inadequate to predict in-hospital mortality and the SOFA score; the APACHE II score should be utilized as a complementation in order to obtain a more accurate prediction.
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Duval, Benoit, Thibaud Besnard, Stefano Mion, Sébastien Leuillet, Olivier Jecker, Louis Labrousse, Alain Rémy, Cedrick Zaouter e Alexandre Ouattara. "Intraoperative changes in blood lactate levels are associated with worse short-term outcomes after cardiac surgery with cardiopulmonary bypass". Perfusion 34, n.º 8 (28 de junho de 2019): 640–50. http://dx.doi.org/10.1177/0267659119855857.
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Background: A high perioperative blood lactate level has been reported to be associated with poor outcomes after cardiac surgery. More than isolated peaks of lactate values, it should be more interesting to take into account changes in intraoperative blood lactate level (∆Lact). This large-scale retrospective study evaluated the relationship between ∆Lact and overall intensive care unit morbidity and 30-day all-cause mortality. Methods: Perioperative data from consecutive patients undergoing on-pump cardiac surgery between September 2010 and June 2016 were retrospectively analysed through our institutional database including clinical, transfusion and laboratory test results implemented prospectively by physicians. Blood lactate levels were initially measured after induction of anaesthesia (baseline) and periodically during the surgery. The ∆Lact was defined as the difference between the highest intraoperative blood lactate and the baseline lactate level and offered the opportunity to stratify patients into four subgroups: ⩽0, 0.1-0.9, 1-1.9 and ⩾2 mmol L−1. Results: From the 7,795 patients found eligible during the study period, 7,447 patients were analysed. The median ∆Lact of our patients was 0.6 (0.3-1) mmol L−1. Most of the studied patients (65.9%) exhibited a ∆Lact between 0.1 and 0.9 mmol L−1. A concentration-dependent relationship was observed between ∆Lact and intensive care unit morbidity and 30-day mortality. After adjustment for co-variables, all ∆Lact > 0 was associated with an increase in overall intensive care unit morbidity. An independent relationship was also found between ∆Lact and 30-day mortality as of a 1 mmol L−1 increase. Conclusion: Our results suggest that ∆Lact is associated with poor short-term outcomes in adult cardiac surgical patients.
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GLEESON, TODD T., e PAULA M. DALESSIO. "Lactate and Glycogen Metabolism in the Lizard Dipsosaurus Dorsalis following Exhaustive Exercise". Journal of Experimental Biology 144, n.º 1 (1 de julho de 1989): 377–93. http://dx.doi.org/10.1242/jeb.144.1.377.
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We evaluated the metabolic mechanisms by which the iguanid lizard Dipsosaurus dorsalis deals with the lactate which accumulates during vigorous exercise. Fasted, cannulated lizards were run for 5 min on a treadmill at 40°C, which elevated whole-body lactate to 24 mmol l−1 and depleted hindlimb glycogen to 70% of resting levels. Oxygen consumption increased fivefold and respiratory exchange ratios approached 2.0. Exhausted animals were then injected intravenously with either [U-14C]lactate or [U-14C]glucose, and allowed to recover quietly on the treadmill at 40°C. After 2h, 79% of the accumulated lactate had been removed and hindlimb muscle glycogen stores had returned to pre-exercise levels. Although blood glucose remained unchanged at 8.6 ± 0.27 mmol l−1 throughout the recovery period, whole-body glucose increased significantly from 1.6 ± 0.23 to 5.5 ± 0.38 mmol l−1 (P<0.05). Based on isotope distribution, 50% of the lactate removed was used to synthesize glucose and glycogen, but only 16% of the lactate was oxidized. Lactate oxidation accounted for about 40% of the post-exercise oxygen consumption. Lactate rather than glucose appeared to be the prevalent substrate for muscle glycogen synthesis under these conditions. These animals appear to employ a strategy of lactate removal which is different from that in mammals; favoring lactate-supported gluco- and glyconeogenesis and rapid muscle glycogen replenishment instead of rapid lactate removal via oxidative pathways.
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Coles, Gerald A., Ram Gokal, Chisholm Ogg, Fiona Jani, Donal T. O'Donoghue, Giovanni C. Cancarinu, Rosario Maiorca, Anders Tranaeus, Dirk Faict e Catherine De Vos. "A Randomized Controlled Trial of a Bicarbonate and a Bicarbonate/Lactate-Containing Dialysis Solution in Capd". Peritoneal Dialysis International: Journal of the International Society for Peritoneal Dialysis 17, n.º 1 (janeiro de 1997): 48–51. http://dx.doi.org/10.1177/089686089701700111.
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Objective To evaluate the safety and efficacy of bicarbonate and bicarbonate/lactate-based PD fluids. Design A randomly allocated prospective controlled trial lasting eight weeks. Setting Five renal units in Europe. Patients Individuals who have been treated by CAPD for at least three months and who have had at least one month's therapy with 40 mmol/L lactate PD fluid. Those with recent infection, diabetes or other serious illness are excluded. Forty-seven individuals have entered the study so far. Interventions Patients are randomly allocated to three groups. Group 1 receive 40 mmol/L lactate dialysate, Group 2 are given 38 mmol/L bicarbonate fluid and Group 3 are tested with a 25 mmol/L bicarbonate and 15 mmol/L lactate dialysate. Outcome measures The primary outcome measure is the plasma bicarbonate level. Adverse events and ease of use of the two-chambered bags used by Groups 2 and 3 are also being assessed. Results To date, plasma bicarbonate levels have been the same in all treatment groups up to the end of the trial period. There are no differences in serum lactate levels. No side effects are attributable to the test fluids. The patients have managed the two-chambered bags successfully. Conclusion This trial is still ongoing, but to date, neutral bicarbonate based fluids have been as effective as lactate dialysate in treating uremic acidosis.
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Shields, Beth A., Kaitlin A. Pruskowski, Alicia M. Williams e Leopoldo C. Cancio. "708 Enteral Nutrition Initiation During Periods of Vasopressor Requirements and Elevated Lactate Levels". Journal of Burn Care & Research 41, Supplement_1 (março de 2020): S185—S186. http://dx.doi.org/10.1093/jbcr/iraa024.294.
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Abstract Introduction Nutrition is a core component of care for the critically ill burn patient. The Society for Critical Care Medicine recommends initiating enteral nutrition (EN) within 4–6 hours of injury for burn patients, while simultaneously recommending waiting until hemodynamic stability is achieved for critical care patients. The goal of this analysis was to evaluate tolerance of EN during periods of different pressor requirements and lactate levels. Methods We performed a retrospective evaluation on all burn patients admitted to our intensive care unit in 2018 who received EN. This performance improvement project was approved by our regulatory compliance division. Lactate levels and vasopressor use just prior to EN initiation, the highest EN rates and gastric residual volumes during the 24 hours after initiation, and ischemic bowel and aspiration after EN initiation were recorded. Significance was accepted at p< 0.05. Results EN was initiated at 30 ± 20 hours after admission in 58 patients with the following characteristics: 47 ± 19 years old, 29 ± 24% TBSA burn, 13 mechanical ventilator days (IQR: 5–30), 15% mortality. The highest EN rate reached was 100 ± 49 mL/hr during the first 24 hours after initiation. Lactate levels were 1.9 mmol/L at the time of EN initiation (IQR: 1.6–2.4 mmol/L), with a maximum of 4.9 mmol/L. Lactate levels did not have a significant correlation with gastric residual volumes (p=0.532). Most (59%) patients did not have vasopressor requirements, but 21% required vasopressin only, 2% required norepinephrine only, and 19% required a combination of vasopressin and norepinephrine. Those who received norepinephrine received 3.3 ± 1.7 mcg/min, with a maximum of 7 mcg/min. There was a significant difference in gastric residual volumes between patients who had no vasopressor requirements compared to those who required vasopressors [13 mL (IQR: 0–200 mL) vs. 240 mL (IQR: 21–430 mL), p=0.014)]; however, the number of patients with gastric residual volumes over 500 mL was not significantly different (3% vs. 17%, p=0.149). When examining patients receiving vasopressin alone, there was a significant but weak correlation between vasopressin dose and gastric residual volumes (p=0.047, R2=0.339); however, when examining only patients receiving norepinephrine, there was no correlation between norepinephrine dose and gastric residual volumes (p=0.905, R2=0.002). There was 1 episode of aspiration and 1 episode of ischemic bowel, both of which occurred 3 days after EN initiation. EN was initiated without vasopressors running and lactate levels were normal in both cases. Conclusions The majority of patients tolerated EN initiation with vasopressor dosing of norepinephrine up to 7 mcg/min and lactate up to 4.9 mmol/L. Applicability of Research to Practice We found no indication for holding EN for lactate levels under 5 mmol/L and norepinephrine under 8 mcg/min.
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Kost, Gerald J., Tam H. Nguyen e Zuping Tang. "Whole-Blood Glucose and Lactate". Archives of Pathology & Laboratory Medicine 124, n.º 8 (1 de agosto de 2000): 1128–34. http://dx.doi.org/10.5858/2000-124-1128-wbgal.
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Abstract Objective.—To assess the effects of 30 of the most commonly used critical care drugs on measurements obtained with trilayer electrochemical biosensors on a reference analyzer (ABL625-GL), to determine metabolic changes in glucose and lactate in vitro, and to formulate guidelines for whole-blood analysis of these 2 analytes. Design.—Serial measurements were taken of changes in glucose and lactate levels caused by metabolism in whole blood in vitro over time. A parallel control study of drug interference with measurements of glucose and lactate in whole blood and of dose-response relationships in whole-blood samples and in plasma samples also was conducted. Results.—At room temperature, whole-blood metabolism decreased glucose levels −2.3% at 15 minutes, −4.6% at 30 minutes, and −6.4% at 45 minutes. Metabolism increased lactate levels 11.4% at 15 minutes, 20.6% at 30 minutes, and 26.7% at 45 minutes in vitro. Paired differences between drug-spiked and control samples were calculated to determine interference (corrected for metabolism). The threshold for determination of interference was ±2 SD from within-day precision, equal to ±0.18 and ±0.10 mmol/L for glucose and lactate, respectively. Only mannitol (C6H14O6) interfered with glucose and lactate measurements. At a concentration of 24 mg/mL, mannitol decreased whole-blood glucose levels by an average of 0.711 mmol/L (12.8 mg/dL) and whole-blood lactate levels by 0.16 mmol/L (1.4 mg/dL). Mannitol interference with measurements may have resulted from suppression of hydrogen peroxide formation in the enzymatic reactions in the biosensors, repartitioning of water between erythrocytes and plasma, or from other mechanisms. Conclusions.—Most critical care drugs had no significant effects on the trilayer electrochemical biosensors. Whole-blood analysis should be performed within 15 minutes for lactate and within 30 minutes for glucose because of metabolism in vitro. Mannitol effects on glucose measurements may be clinically significant in mannitol-induced acute renal failure and therefore should be considered for appropriate diagnosis and treatment of critically ill patients.
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GLASS, KATHLEEN A., DAWN A. GRANBERG, ANGELIQUE L. SMITH, ANN MARIE McNAMARA, MARGARET HARDIN, JANE MATTIAS, KEVIN LADWIG e ERIC A. JOHNSON. "Inhibition of Listeria monocytogenes by Sodium Diacetate and Sodium Lactate on Wieners and Cooked Bratwurst". Journal of Food Protection 65, n.º 1 (1 de janeiro de 2002): 116–23. http://dx.doi.org/10.4315/0362-028x-65.1.116.
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The inhibition of Listeria monocytogenes by sodium lactate and sodium diacetate was evaluated for wieners containing pork, turkey, and beef and for cooked bratwurst containing beef and pork. Both products were supplied by commercial manufacturers. Treated products were surface-inoculated with 105 CFU of L. monocytogenes per package and vacuum-packed in gas-impermeable pouches. Wieners were stored for 60 days at 4.5°C, and bratwurst were stored for 84 days at 3 and 7°C. A surface treatment that consisted of dipping wieners into solutions containing ≤6% lactate and ≤3% diacetate for 5 s did not delay pathogen growth compared with that for untreated wieners. In additional trials, the antilisterial activity of lactate and diacetate in wiener and bratwurst formulations was evaluated. Lactate levels ranged from 1.32 to 3.4%, and diacetate was evaluated at 0.1 and 0.25%. The growth of L. monocytogenes was delayed for 4 and 12 weeks at 7 and 3°C, respectively, on uncured, unsmoked bratwurst formulated with 3.4% lactate/0.1% diacetate, compared with 1 and 2 weeks, respectively, for the formulation containing 2% lactate. L. monocytogenes grew by ≥1 log unit after 4 weeks' storage at 3 or 7°C on cured, smoked bratwurst without lactate or diacetate, but growth was inhibited for 12 weeks on cured, smoked bratwurst formulated with 3.4% lactate and 0.1% diacetate. Sodium lactate levels of ≥3% and combinations of ≥1% lactate plus ≥0.1% diacetate prevented listerial growth on wieners stored for 60 days at 4.5°C. These results indicate that dipping wieners in lactate-diacetate solutions is not an efficient way to apply these antimicrobial agents to wieners. However, the inclusion of combinations of sodium lactate and sodium diacetate in wiener or bratwurst formulations inhibits the growth of L. monocytogenes at ≤7°C, and an additional margin of safety was observed for products that are cured and smoked.
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Thapa, Mukesh, Ryong Sung e Yun Seok Heo. "A Dual Electrode Biosensor for Glucose and Lactate Measurement in Normal and Prolonged Obese Mice Using Single Drop of Whole Blood". Biosensors 11, n.º 12 (9 de dezembro de 2021): 507. http://dx.doi.org/10.3390/bios11120507.
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Understanding the levels of glucose (G) and lactate (L) in blood can help us regulate various chronic health conditions such as obesity. In this paper, we introduced an enzyme-based electrochemical biosensor adopting glucose oxidase and lactate oxidase on two working screen-printed carbon electrodes (SPCEs) to sequentially determine glucose and lactate concentrations in a single drop (~30 µL) of whole blood. We developed a diet-induced obesity (DIO) mouse model for 28 weeks and monitored the changes in blood glucose and lactate levels. A linear calibration curve for glucose and lactate concentrations in ranges from 0.5 to 35 mM and 0.5 to 25 mM was obtained with R-values of 0.99 and 0.97, respectively. A drastic increase in blood glucose and a small but significant increase in blood lactate were seen only in prolonged obese cases. The ratio of lactate concentration to glucose concentration (L/G) was calculated as the mouse’s gained weight. The results demonstrated that an L/G value of 0.59 could be used as a criterion to differentiate between normal and obesity conditions. With L/G and weight gain, we constructed a diagnostic plot that could categorize normal and obese health conditions into four different zones. The proposed dual electrode biosensor for glucose and lactate in mouse whole blood showed good stability, selectivity, sensitivity, and efficiency. Thus, we believe that this dual electrode biosensor and the diagnostic plot could be used as a sensitive analytical tool for diagnosing glucose and lactate biomarkers in clinics and for monitoring obesity.
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Erum, Uzma, Tahira Perveen Umer, Shafiq-ur Rehman Arain, Muhammad Rashid Ahmed e Lubna Nazir. "Significance of Elevated Synovial Fluid Lactic Acid and Lactate Dehydrogenase Levels in Differentiating Between Septic Arthritis, Inflammatory Arthritis and Non-Inflammatory Arthritis". Pakistan Armed Forces Medical Journal 72, SUPPL-2 (6 de junho de 2022): S276–79. http://dx.doi.org/10.51253/pafmj.v72isuppl-2.4369.
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Objective: To determine the lactic acid and lactate dehydrogenase levels in synovial fluid and differentiate between inflammatory and non-inflammatory arthritis.
Study Design: Cross-sectional study.
Place and Duration of Study: Department of Rheumatology, Liaquat National Hospital, Karachi, from Feb to May 2019.
Methodology: All patients of age >18 years, of either gender, who presented with knee joint effusion were enrolled in the study. Synovial fluid aspiration for the analysis of lactate and lactate dehydrogenase (LDH) was done for all patients.
Results: Seventy-seven patients were enrolled, of which 75 were included in the analysis. Two patients were excluded as one had lymphoma and the other had recent joint trauma. 31 (41.3 %) patients had non-inflammatory, or osteoarthritis, and 44 (58.7 %) had inflammatory arthritis. The mean value of synovial LDH in inflammatory and non-inflammatory arthritis was 737.38 ± 102.76 mmol/L and 265.5 ± 17.43 mmol/L, respectively, (p<0.001). The mean value of synovial lactate in inflammatory arthritis (32.16 ± 2.84 mmol/L) was higher than the mean value of synovial lactate in non-inflammatory arthritis (19.81 ± 1.08 mmol/L) (p<0.001). There mean plasma LDH in inflammatory arthritis and non-inflammatory arthritis was 495.77 ± 41.67 mg/dl and 437.90 ± 30.99 mg/dl, respectively (p>0.05). The plasma lactate in inflammatory arthritis and noninflammatory arthritis was 12.84 ± 0.59 mg/dl and 12.97 ± 0.78 mg/dl, respectively (p>0.05).
Conclusion: Synovial fluid lactic acid and synovial LDH can serve as rapid diagnostic and cost-effective tests to differentiate between non-inflammatory and inflammatory arthritis.
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Lv, Xuemei, Qian Ren, Lingli Zhou, Yanyan Geng, Jia Song, A. Mina, Basang Puchi, Senlin Yang, Shuyou Meng e Lihui Yang. "Safety of Metformin Therapy in Patients with Type 2 Diabetes Living on an Oxygen-Deficient Plateau, Tibet, China". Experimental and Clinical Endocrinology & Diabetes 126, n.º 07 (8 de novembro de 2017): 460–64. http://dx.doi.org/10.1055/s-0043-113830.
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Abstract Background In the general population, the absolute risk of lactic acidosis in patients treated with metformin appears to be low. However, in the Tibetan plateau, an extreme oxygen-deficient environment, there are no data available concerning the safety of metformin. The aim of our study is to assess the safety of metformin in people of the plateau area. Methods We conducted an observational cross-sectional study in Tibet. All the 166 subjects were divided into two groups: T2DM+metformin group and T2DM group. Clinical characteristics as well as lactate levels were measured in all subjects. The association between lactate, metformin use, FBG, HbA1c, eGFR, and other potential predictors was evaluated. Results A total of 166 subjects were enrolled in this study. Average age was 51.7±12.3 years, and the percentage of male participants was 67%. The median level of lactate was 1.89 (1.35–2.91) mmol/L in all the subjects. The mean (±SD) lactate concentration in patients treated with metformin, versus those who were not, was 2.35±1.42 vs 2.29±1.65 mmol/L, respectively (mean difference 0.06 mmol/L, 95% CI: −0.48–0.60, P=0.556). FBG was significantly higher in the high lactate group than in the low lactate group (12.1±4.1 vs. 10.5±4.0 mmol/L, P=0.018). Similarly, HbA1c level was also significantly higher in the high lactate group than in the low lactate group (12.3±2.6 vs. 11.0±3.0%, P=0.008). Conclusions In the oxygen-deficient Tibetan plateau, lactate concentration among patients on metformin was not significantly different from patients without metformin. The level of lactate was significantly associated with FBG and HbA1c levels.
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Chebl, Ralphe Bou, Hani Tamim, Gilbert Abou Dagher, Musharaf Sadat, Farhan Al Enezi e Yaseen M. Arabi. "Serum Lactate as an Independent Predictor of In-Hospital Mortality in Intensive Care Patients". Journal of Intensive Care Medicine 35, n.º 11 (9 de junho de 2019): 1257–64. http://dx.doi.org/10.1177/0885066619854355.
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Purpose: The aim of this study was to check if serum lactate was independently associated with mortality among critically ill patients. Materials and Methods: This was a single-center, retrospective cohort study. All adult patients (>18 years of age) who had at least 1 measurement of lactate within 24 hours of admission to intensive care unit (ICU) between January 2002 and December 2017 were included in the analysis. Patients were stratified into 3 groups: those with a serum lactate of <2 mmol/L (normal level), 2 to 4 mmol/L (intermediate level), and >4 mmol/L (high level). The primary outcome was in-hospital mortality. Secondary outcomes included ICU and hospital lengths of stay and mechanical ventilation duration. To determine the association between lactate level and hospital mortality, bivariate and multivariate logistic regression analyses were performed. Results: Of the 16,447 patients admitted to the ICU, 8167 (49.65%) had normal levels, 4648 (28.26%) had an intermediate, and 3632 (22.09%) had high lactate levels. Hospital mortality was the highest in high lactate level, followed by the intermediate and the normal level group (47.4% vs 26.5% vs 19.6%; P < .0001). Intermediate and high lactate levels were independent predictors of hospital mortality (odds ratio [OR], 1.32; 95% confidence interval [CI]: 1.20-1.46, and 1.94; 95% CI, 1.75-2.16, respectively) as well as ICU mortality (OR, 1.47; 95% CI, 1.30-1.66 and 2.56; 95% CI, 2.27-2.88, respectively). Conclusions: Intensive care unit serum lactate is associated with increased ICU and hospital mortality, independent of comorbidities, organ dysfunction, or hemodynamic status.
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Murtuza, F., AJ Farrier, M. Venkatesan, R. Smith, A. Khan, CE Uzoigwe e G. Chami. "Is there an association between body temperature and serum lactate levels in hip fracture patients?" Annals of The Royal College of Surgeons of England 97, n.º 7 (1 de outubro de 2015): 513–18. http://dx.doi.org/10.1308/rcsann.2015.0012.
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Introduction Hyperlactataemia is associated with adverse outcomes in trauma cases. It is thought to be the result of anaerobic respiration during hypoperfusion. This produces much less energy than complete aerobic glycolysis. Low body temperature in the injured patient carries an equally poor prognosis. Significant amounts of energy are expended in maintaining euthermia. Consequently, there may be a link between lactate levels and dysthermia. Hyperlactataemia may be indicative of inefficient energy production and therefore insufficient energy to maintain euthermia. Alternatively, significant amounts of available oxygen may be sequestered in thermoregulation, resulting in anaerobic respiration and lactate production. Our study investigated whether there is an association between lactate levels and admission body temperature in hip fracture patients. Furthermore, it looked at whether there is a difference in the mean lactate levels between hip fracture patients with low (<36.5°C), normal (36.5–37.5°C) and high (>37.5°C) body temperature on admission, and for patients who have low body temperature, whether there is a progressive rise in serum lactate levels as body temperature falls. Methods The admission temperature and serum lactate of 1,162 patients presenting with hip fracture were recorded. Patients were divided into the euthermic (body temperature 36.5–37.5°C), the pyrexial (>37.5°C) and those with low body temperature (<36.5°C). Admission lactate and body temperature were compared. Results There was a significant difference in age between the three body temperature groups (p=0.007). The pyrexial cohort was younger than the low body temperature group (mean: 78 vs 82 years). Those with low body temperature had a higher mean lactate level than the euthermic (2.2mmol/l vs 2.0mmol/l, p=0.03). However, there was no progressive rise in serum lactate level as admission temperature fell. Conclusions The findings suggest that in hip fracture patients, the body attempts initially to maintain euthermia, incurring an oxygen debt. This would explain the difference in lactate level between the low body temperature and euthermic cohorts. The fact that there is no correlation with the degree of temperature depression and lactate levels indicates that the body does not fuel thermohomeostasis indefinitely with oxygen. Instead, in part, it abandons thermoregulatory mechanisms. Consequently, in this population, active rewarming may be indicated rather than depending on patients’ own thermogenic ability.
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Nolph, Karl D., Zbylut J. Twardowski, Ramesh Khanna, Barbara F. Prowant, Leonor P. Ponferrada, Lois M. Schmidt e Harold L. Moore. "Tidal Peritoneal Dialysis with Racemic or L-Lactate Solutions". Peritoneal Dialysis International: Journal of the International Society for Peritoneal Dialysis 10, n.º 2 (abril de 1990): 161–64. http://dx.doi.org/10.1177/089686089001000208.
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To see if rapid lactate absorption on tidal peritoneal dialysis (TPD) would overwhelm D-Iactate metabolism using racemic lactate andlor L-Iactate metabolism using all L-Iactate, five patients underwent a- h TPD treatments with racemic lactate solution one day and with L-Iactate another. Lactate concentrations (total) were 40 mmolelL, flow rates 27.3 LIB h, tidal and reservoir volumes each 1.5L, tidal cycles 24–26 min, and net ultrafiltration per tidal cycle 70 to 99 mL. Results: Mean absorptions of D and L-Iactate were 24.2 and 25.1%, respectively, compared to glucose at 14.6%. Urea clearances averaged 21.4 mLlmin. Mean blood D-Iactates at baseline were 0.6 ± 0.5 SD mmolelL and after a h of TPD were 0.6 ± 0.4 and 0.7 ± 0.3 using L-Iactate and racemic solutions, respectively; similar values for L-Iactate were 1.2 ± 0.3 at baseline and 1.2 ± 0.3 and 1.2 ± 0.5 after a h with L-Iactate and racemic solutions. d blood pH values were + 0.02 ± 0.01 and + 0.04 ± 0.03, while d bicarbonate values were + 1.7 ± 0.9 and + 0.7 ± 1.0 for the all L and racemic studies, respectively. The total mmoles of L-Iactate absorbed per a h of TPD with all L solution (>300 mmoles) are greater than ever reported for peritoneal dialysis, but did not increase blood lactate levels. It would seem that either type of solution is suitable for TPD. Absorptions and metabolic rates are similar for L-Lactate and D-Lactate.
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Kerslake, Rachel, Suzana Panfilov, Nashrah Mustafa, Marcia Hall, Ioannis Kyrou, Harpal Randeva, Emmanouil Karteris e Richard Godfrey. "Elevated Circulating Lactate Levels and Widespread Expression of Its Cognate Receptor, Hydroxycarboxylic Acid Receptor 1 (HCAR1), in Ovarian Cancer". Journal of Clinical Medicine 12, n.º 1 (27 de dezembro de 2022): 217. http://dx.doi.org/10.3390/jcm12010217.
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Background: Augmented glycolysis in cancer cells is a process required for growth and development. The Warburg effect provides evidence of increased glycolysis and lactic acid fermentation in cancer cells. The lactate end-product of glycolysis is receiving growing traction for its role as a cell signalling molecule. Ovarian cancer (OvCa) is also characterised by altered glucose metabolism. We aim to explore circulating lactate levels in patients with high-grade serous OvCa (HGSOC) and to elucidate the expression of the lactate receptor hydroxycarboxylic acid receptor 1 (HCAR1) in OvCa. Methods: HCAR1 expression was detected in patient biopsy cores using immunohistochemistry, while lactate was measured from whole blood with a Biosen-C line clinic measuring system. Results: We noted significantly elevated lactate levels in OvCa patients (4.3 ± 1.9 mmol/L) compared with healthy controls (1.4 ± 0.6 mmol/L; p < 0.0001), with an AUC of 0.96. The HCAR1 gene is overexpressed in OvCa compared to healthy controls (p < 0.001). Using an OvCa tissue microarray (>75% expression in 100 patients), high protein expression was also recorded across all epithelial OvCa subtypes and ovarian normal adjacent tissue (NAT). Conclusions: Lactate monitoring is a simple, cost-efficient test that can offer point-of-care results. Our data suggest that the potential of circulating lactate as a screening biomarker in OvCa merits further research attention.
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Ząbczyk, Michał, Joanna Natorska, Agnieszka Janion-Sadowska, Krzysztof P. Malinowski, Marianna Janion e Anetta Undas. "Elevated Lactate Levels in Acute Pulmonary Embolism Are Associated with Prothrombotic Fibrin Clot Properties: Contribution of NETs Formation". Journal of Clinical Medicine 9, n.º 4 (30 de março de 2020): 953. http://dx.doi.org/10.3390/jcm9040953.
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Background: Elevated plasma lactate levels correlate with high mortality rate in acute pulmonary embolism (PE) patients. We hypothesized that elevated lactate levels correlate with prothrombotic fibrin clot properties and enhanced neutrophil extracellular trap (NET) formation in acute PE. Methods: As many as 126 normotensive acute PE patients (aged 58 ± 14 years) were enrolled. Plasma fibrin clot permeability (Ks), clot lysis time (CLT), endogenous thrombin potential (ETP), citrullinated histone H3 (citH3), and plasminogen activator inhibitor-1 antigen (PAI-1), together with plasma L-lactate levels were evaluated on admission. Results: Lactate levels ≥2 mM were found in 70 (55.6%) patients in whom we observed 29% higher neutrophil count and 45% elevated plasma citH3 levels. Elevated lactate levels were associated with more prothrombotic fibrin properties as reflected by 11% reduced Ks, 13% longer CLT, along with 11% increased ETP. Lactate levels were positively associated with plasma citH3 concentrations, ETP, CLT, and PAI-1 (p < 0.05). An increase of lactate levels by 1 mM leading to the prolongation of CLT by 8.82 min was shown in the linear regression. Conclusions: Our findings suggest a new mechanism contributing to a negative impact of elevated lactate levels on prognosis in acute PE patients, in particular hypofibrinolysis, associated with enhanced NET formation.