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Effect of rapid fluid administration on the prognosis of septic shock patients with isolated hyperlactatemia: A prospective multicenter observational study

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Abstract
Background: We aimed to investigate the association between initial fluid resuscitation in septic shock patients
with isolated hyperlactatemia and outcomes.
Methods: This 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 thosewho received 30 mL/kg of fluid within 3 or 6 h and thosewho 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).
Results: A 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).
Conclusions: Initial 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.
Author(s)
권운용김원영박유석서길준손동희신태건유승목이희경임태호최성혁Byuk Sung KoKyuseok Kim
Issued Date
2021
Type
Article
Keyword
AnalysisEmergency medicineFluid resusitationHyperlactatemiaMedical researchMedicineExperimentalMortalityPrognosisSeptic shock
DOI
10.1016/j.jcrc.2021.07.003
URI
https://oak.ulsan.ac.kr/handle/2021.oak/8276
https://ulsan-primo.hosted.exlibrisgroup.com/primo-explore/fulldisplay?docid=TN_cdi_proquest_miscellaneous_2555108345&context=PC&vid=ULSAN&lang=ko_KR&search_scope=default_scope&adaptor=primo_central_multiple_fe&tab=default_tab&query=any,contains,Effect%20of%20rapid%20fluid%20administration%20on%20the%20prognosis%20of%20septic%20shock%20patients%20with%20isolated%20hyperlactatemia:%20A%20prospective%20multicenter%20observational%20study&offset=0&pcAvailability=true
Publisher
JOURNAL OF CRITICAL CARE
Location
미국
Language
영어
ISSN
0883-9441
Citation Volume
66
Citation Number
6
Citation Start Page
154
Citation End Page
159
Appears in Collections:
Medicine > Medicine
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