Tag Archives: Epidemiology/Outcomes

Peak Lactate and Patient Outcome Following High-Risk Gastrointestinal Surgery

The association between hyperlactatemia and adverse outcome in patients admitted to intensive care units (ICUs) following gastrointestinal surgery has not been reported. Creagh-Brown et al therefore set out to explore the hypothesis that in a large cohort of gastrointestinal surgical patients, the peak serum lactate (in the first 24 hours) observed in patients admitted to the ICU following surgery is associated with unadjusted and severity-adjusted acute hospital mortality and that the strength of association is greater in patients admitted following emergency surgery than in patients admitted following elective surgery.

They found that elevated lactate is independently associated with in-hospital mortality in the postoperative gastrointestinal surgical patient and is no less significant in the context of elective surgery.

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Is Fluid Overload Associated with Mortality in Children?

Early fluid resuscitation remains an integral therapy in most critically ill children with sepsis.  However, as of late, an increasing body of literature (i.e., studies by Modem et al and Sutherland et al) has reported that fluid overload in critical illness may be associated with increasing mortality. Sinitsky and colleagues investigated the association of early fluid overload with respiratory parameters and mortality in a general pediatric intensive care unit (PICU) population.

The authors found that, in this general PICU population, fluid overload percent (%FO) at 48 hours was associated with oxygenation index at 48 hours and need for invasive ventilation in survivors. However, no association was detected between %FO and mortality.

Read the full Concise Critical Appraisal by logging into the SCCM eCommunity. Concise Critical Appraisal is a regular feature aimed at highlighting the best and most relevant literature from a variety of academic journals and encouraging discussion around recent studies and research.