Key result
Blood lactate alone predicts survival in circulatory shock with ~12% misclassification, unimproved by pyruvate.
Why the study?
The study investigated the extent to which increases in arterial blood lactate and pyruvate serve as measures of oxygen deficit and irreversible injury during shock states.
Does the measurement of lactate, pyruvate, or their derived indices predict survival in patients with circulatory shock?
Population
Wistar rats with hemorrhagic shock and 142 patients with clinical circulatory shock
Comparison
Measurement of lactate, pyruvate, lactate/pyruvate ratio, and excess lactate
Design
Empirical observational study with experimental and clinical components
Authors
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Arterial lactate reliably prognosticates shock survival; supports its primacy over pyruvate ratios in future risk models.
Observational (n=142)
Does the measurement of lactate, pyruvate, or their derived indices predict survival in patients with circulatory shock?
Absolute Event Rate: 12% vs 21%
Arterial lactate alone is a reliable and sensitive predictor of survival in circulatory shock, and the addition of pyruvate or derived indices (L/P ratio, excess lactate) does not improve prognostic accuracy.
Weil et al. (1970) conducted an observational in Circulatory shock (n=142). Blood lactate measurement vs. Pyruvate, lactate/pyruvate ratio, and excess lactate was evaluated on Probability of misclassification for survival. Blood lactate alone was a reliable predictor of survival in circulatory shock (12% misclassification probability), and neither pyruvate nor lactate/pyruvate ratio improved predictability.
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