Effect of rapid fluid administration on the prognosis of septic shock patients with isolated hyperlactatemia: A prospective multicenter observational study |
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| Affiliation: | 1. Division of Critical Care Medicine, Department of Medicine, University of British Columbia, Vancouver, British Columbia, Canada;2. Department of Statistics and Public Policy, Heinz College, Carnegie Mellon University, Pittsburgh, PA, United States of America;3. Department of Cardiothoracic Surgery, Heartlink ECMO Centre, Glenfield Hospital, Leicester, United Kingdom;4. Division of Pediatric Cardiothoracic Surgery, Department of Cardiothoracic and Vascular Surgery, Children''s Hospital at Montefiore, Bronx, New York, NY, United States of America;1. Department of Anaesthesiology and Critical Care, Beaujon Hospital, DMU Parabol, AP-HP Nord, Université de Paris, 92110 Clichy, France;2. Groupe Hospitalier Universitaire APHP-Sorbonne Université, site Pitié-Salpêtrière, Service de Médecine Intensive et Réanimation (Département R3S), F-75013 Paris, France;3. Sorbonne Université, INSERM, UMRS1158 Neurophysiologie Respiratoire Expérimentale et Clinique, F-75005 Paris, France;4. APHP, Département Epidémiologie Biostatistiques et Recherche Clinique, Hôpital Beaujon, 92110 Clichy, France;5. INSERM, CIC-EC 1425, Hôpital Bichat, 75018 Paris, France;1. Department of Nephrology, Ghent University Hospital, Ghent, Belgium;2. Department of Critical Care Medicine, Ghent University Hospital, Ghent, Belgium;1. Graduation Program in Health Sciences, University of Brasília (UnB), Brasília, Federal District, Brazil;2. Nursing School, School of Health Sciences (ESCS), Brasília, Federal District, Brazil;3. Graduation Program in Nursing, University of Brasília (UnB), Brasília, Federal District, Brazil;4. Regulation Center of Federal District, Secretary of State of Health of the Federal District, Federal District, Brazil;5. Multiprofessional Residency Program in Primary Care, Oswaldo Cruz Foundation (FIOCRUZ), Federal District, Brazil;6. Law School, University Center of Brasilia (UniCEUB), Brasília, Federal District, Brazil;7. Graduation Program in Health Sciences, School of Health Sciences (ESCS), Brasília, Federal District, Brazil;8. Medical School, School of Health Sciences (ESCS), Brasília, Federal District, Brazil;1. Polyvalent Intensive Care Unit, Department of Anesthesiology and Critical Care, Institut Paoli-Calmettes, 232 boulevard de Sainte Marguerite, 13009 Marseille, France;2. Hematology Department, Institut Paoli-Calmettes, 232 boulevard de Sainte Marguerite, 13009 Marseille, France |
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| Abstract: | BackgroundWe aimed to investigate the association between initial fluid resuscitation in septic shock patients with isolated hyperlactatemia and outcomes.MethodsThis multicenter prospective study was conducted using the data from the Korean Shock Society registry. Patients diagnosed with isolated hyperlactatemia between October 2015 and December 2018 were included and divided into those who received 30 mL/kg of fluid within 3 or 6 h and those who did not receive. The primary outcome was in-hospital mortality; the secondary outcomes were intensive care unit (ICU) admission, length of ICU stay, mechanical ventilation, and renal replacement therapy (RRT).ResultsA total of 608 patients were included in our analysis. The administration of 30 mL/kg crystalloid within 3 or 6 h was not significantly associated with in-hospital mortality in multivariable logistic regression analysis ([OR, 0.8; 95% CI, 0.52–1.23, p = 0.31], [OR, 0.96; 95% CI, 0.59–1.57, p = 0.88], respectively). The administration of 30 mL/kg crystalloid within 3-h was not significantly associated with mechanical ventilation and RRT ([OR, 1.19; 95% CI, 0.77–1.84, p = 0.44], [OR, 1.2; 95% CI, 0.7–2.04, p = 0.5], respectively). However, the administration of 30 mL/kg crystalloid within 6 h was associated with higher ICU admission and RRT ([OR, 1.57; 95% CI, 1.07–2.28, p = 0.02], [OR, 2.08; 95% CI, 1.19–3.66, p = 0.01], respectively).ConclusionsInitial fluid resuscitation of 30 mL/kg within 3 or 6 h was neither associated with an increased or decreased in-hospital mortality in septic shock patients with isolated hyperlactatemia. |
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