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Rapid decrease in plasma D-lactate as an early potential predictor of diminished 28-day mortality in critically ill septic shock patients

  • Vincent Sapin , Laurent Nicolet , Bruno Aublet-Cuvelier , Fabienne Sangline , Laurence Roszyk , Bernard Dastugue , Nicole Gazuy , Patrice Deteix and Bertrand Souweine
Published/Copyright: September 21, 2011
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Clinical Chemistry and Laboratory Medicine (CCLM)
From the journal Clinical Chemistry and Laboratory Medicine (CCLM) Volume 44 Issue 4

Abstract

Background: Splanchnic ischemia plays a major role in the development of organ failure during septic shock. Plasma D-lactate has been proposed as a better marker of splanchnic hypoperfusion than L-lactate. We studied the prognostic ability of plasma D- and L-lactate levels.

Methods: A prospective study was performed in an intensive care unit and included patients with septic shock. Two samples for plasma D- and L-lactate determination were collected: the first within 6h after the patient met the criteria for septic shock (day 1) and the second 24h later (day 2).

Results: In univariate analysis, day 1 plasma D- and L-lactate values were associated with 28-day mortality. For plasma D- and L- lactate, the area under the receiver operating characteristic curve was 0.68±0.09 and 0.84±0.07 on day 1 (p=0.09), and 0.74±0.10 and 0.90±0.07 on day 2 (p=0.06), respectively. In survivors, D-lactate levels decreased between day 1 and day 2 (p=0.03), but L-lactate did not (p=0.29). In septic shock patients, plasma D- and L-lactate levels reliably discriminate between survivors and non-survivors. The prognostic ability of plasma L-lactate was better than that of plasma D-lactate.

Conclusion: A rapid decrease in plasma D-lactate during the course of septic shock could indicate reduced 28-day mortality.

Keywords: D-lactic acid; L-lactic acid; mortality; prognostic value; septic shock
Corresponding author: Vincent Sapin, Laboratoire de Biochimie Médicale, Hôpital Gabriel Montpied, B.P. 69, 63003 Clermont-Ferrand Cedex, France Phone: +33-4-73178174, Fax: +33-4-73276132,

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Received: 2005-11-16
Accepted: 2006-1-16
Published Online: 2011-9-21
Published in Print: 2006-4-1

©2006 by Walter de Gruyter Berlin New York

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https://doi.org/10.1515/CCLM.2006.086
Keywords for this article
D-lactic acid; L-lactic acid; mortality; prognostic value; septic shock

Articles in the same Issue

  1. Natriuretic peptides and evidence-based quality specifications
  2. Preanalytical variability: the dark side of the moon in laboratory testing
  3. Clinical relevance of biological variation: the lesson of brain natriuretic peptide (BNP) and NT-proBNP assay
  4. Hepatorenal syndrome
  5. Modified Levey-Jennings charts for calculated laboratory tests
  6. Increased free malondialdehyde concentrations in smokers normalise with a mixed fruit and vegetable juice concentrate: a pilot study
  7. The exponentially weighted moving average (EWMA) rule compared with traditionally used quality control rules
  8. Intermethod calibration of alanine aminotransferase (ALT) and γ-glutamyltransferase (GGT) results: application to Fibrotest® and Actitest® scores
  9. Comparison of TEST 1 with SRS 100 and ICSH reference method for the measurement of the length of sedimentation reaction in blood
  10. Multicenter evaluation of the interference of hemoglobin, bilirubin and lipids on Synchron LX-20 assays
  11. Technical evaluation of the Beckman Coulter OV-Monitor (CA 125 antigen) immunoassay
  12. Erythrocyte membrane Na+,K+-ATPase and Mg2+-ATPase activities in subjects with methylenetetrahydrofolate reductase (MTHFR) 677 C→T genotype and moderate hyperhomocysteinaemia. The role of L-phenylalanine and L-alanine
  13. Matrix metalloproteinases and their inhibitors in different acute stroke subtypes
  14. Pyrosequencing protocol requiring a unique biotinylated primer
  15. Detection of antibodies against 60-, 65- and 70-kDa heat shock proteins in paediatric patients with various disorders using Western blotting and ELISA
  16. Quantitative determination of erythrocyte folate vitamer distribution by liquid chromatography-tandem mass spectrometry
  17. Time-level relationship between indicators of oxidative stress and Glasgow Coma Scale scores of severe head injury patients
  18. Stepwise strategies in analysing haematuria and leukocyturia in screening
  19. Elevation of serum cerebral injury markers correlates with serum choline decline after coronary artery bypass grafting surgery
  20. Drug screening in urine by cloned enzyme donor immunoassay (CEDIA) and kinetic interaction of microparticles in solution (KIMS): a comparative study
  21. Release of anandamide from blood cells
  22. Rapid decrease in plasma D-lactate as an early potential predictor of diminished 28-day mortality in critically ill septic shock patients
  23. Evaluation of an immunoassay of whole blood sirolimus in pediatric transplant patients in comparison with high-performance liquid chromatography/tandem mass spectrometry
  24. Sample processing and its preanalytical impact on the measurement of circulating matrix metalloproteinases
  25. Physiological matrix metalloproteinase (MMP) concentrations: comparison of serum and plasma specimens
  26. Importance of the functional sensitivity determination of a serum hyaluronic acid assay for the prediction of liver fibrosis in patients with features of the metabolic syndrome
  27. The dilemma of invasive and non-invasive investigations for adult and paediatric non-alcoholic fatty liver disease: has the time come for a new biochemical marker?
  28. Is cystatin C a reliable renal marker in trauma?
  29. On the independence of intraindividual reference values
  30. Sixth International Symposium on Molecular Diagnostics, Graz, Austria, May 25-27, 2006
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