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Internal and Emergency Medicine

, Volume 14, Issue 6, pp 999–1001 | Cite as

Targeting peripheral perfusion versus serum lactate levels in septic shock

  • Marianna PorzioEmail author
  • Guido Baldini
  • Cristiana Di Maggio
  • Gruppo di Autoformazione Metodologica (GrAM)
THE CUTTING EDGE: RESEARCH UPDATE
  • 110 Downloads

Background

Sepsis is life-threatening organ dysfunction caused by a dysregulated host response to infection [1, 2]. Sepsis and septic shock are major healthcare problems, affecting millions of people around the world each year, and killing as many as one in four [3].

Early resuscitation is a key factor for the stabilization of sepsis-induced tissue hypoperfusion and is crucial to limit adverse outcome and death, especially in patients with septic shock.

Serum lactate is widely used in sepsis and, despite it is not a direct measure of tissue perfusion, it can serve as a surrogate. The Surviving Sepsis Campaign proposes to guide resuscitation by reassessment of blood lactate levels every 2–4 h until normalization according to randomized controlled trials [4]. However, the persistent increase of lactate may be related to other causes than tissue hypoperfusion, i.e., severe hypoxemia. Therefore, finding an alternative resuscitation targets becomes relevant in sepsis research.

Capillary...

Notes

Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflict of interest.

Statement of human and animal rights

This article does not contain any studies with human and animals performed by any of the authors.

Informed consent

Informed consent was obtained from all individual participants included in the study.

References

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    Rusconi AM, Bossi I, Lampard JG et al (2015) Early goal-directed therapy vs usual care in the treatment of severe sepsis and septic shock: a systematic review and meta-analysis. Intern Emerg Med 10(6):731–743CrossRefPubMedGoogle Scholar
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    Hernández G, Ospina-Tascón GA GAANDROMEDA-SHOCK Investigators and the Latin America Intensive Care Network (LIVEN) (2019) Effect of a resuscitation strategy targeting peripheral perfusion status vs serum lactate levels on 28-day mortality among patients with septic shock: the ANDROMEDA-SHOCK randomized clinical trial. JAMA 321(7):654–664CrossRefPubMedPubMedCentralGoogle Scholar

Copyright information

© Società Italiana di Medicina Interna (SIMI) 2019

Authors and Affiliations

  1. 1.UOC Pronto Soccorso e Medicina D’Urgenza, Fondazione IRCCS Ca’ Granda, Ospedale Maggiore PoliclinicoUniversità Degli Studi Di MilanoMilanItaly

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