Prognostic value of lactate/albumin compared to lactate clearance in resuscitation of patients with septic shock admitted to intensive care unit

Abstract

To date, severe sepsis and septic shock are among the most important reasons for admission to the hospital and the most important issue of mortality related health care worldwide. Since there is no reliable measure to compare the prognostic methods of septic shock in critically ill patients, in this study our aim was to compare the prognostic value of lactate/albumin with lactate clearance in resuscitation of septic shock patients admitted to the intensive care unit. Methods and Materials: All patients admitted to the general ICU of Imam Reza and Shohada hospitals with a diagnosis of septic shock from July 6, 2018 to July 6, 2020, accounting for 151 patients were included in the study. Lactate assessment was performed at the beginning of arrival and the ratio of lactate to albumin was calculated, as well as lactate assessment at 6, 12 and 24 hours to calculate lactate clearance. Mortality, length of hospital stay in ICU and mechanical ventilation were recorded for all patients. Data were analyzed using Spss Ver 22 software. Results were reported as frequency (percentage) as well as median (mid-quarter range). P <0.05 was considered as a statistically significant level. Results: Lactate/Albumin ratio was significantly higher in dead septic patients than in living patients. Also, the highest rate of lactate reduction in surviving patients compared to patients who died in 24 hours was lactate measurement. Besides, lactate clearance was at 12 hours and lactate clearance was at 6 hours, respectively. A significant inverse correlation was observed between lactate/albumin ratio and lactate clearances at 6, 12, and 24 hours with factors such as ICU length of stay, duration of mechanical ventilation, vasopressor-dependent days, and mortality, as lactate clearance increased. After 24 hours, the amount of these variables decreased.