The association of early combined lactate and glucose levels with subsequent renal and liver dysfunction and hospital mortality in critically ill patients

The development of renal and liver dysfunction may be accompanied by initially subtle derangements in the gluconeogenetic function. Discrepantly low glucose levels combined with high lactate levels might indicate an impaired Cori cycle. Our objective was to examine the relation between early lactate...

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Published in:Critical care (London, England) England), 2017-08, Vol.21 (1), p.218-218, Article 218
Main Authors: Freire Jorge, Pedro, Wieringa, Nienke, de Felice, Eva, van der Horst, Iwan C C, Oude Lansink, Annemieke, Nijsten, Maarten W
Format: Article
Language:English
Subjects:
Acute kidney injury
Age
Analysis
Chemical properties
Cori cycle
Critical care
Critical illness
Critically ill
Dextrose
Diabetes
Enzymes
Glucose
Health aspects
Heart attack
Hospitals
Hyperglycemia
Hypoglycemia
Insulin
Intensive care
Kidney diseases
Lactate
Lactates
Liver diseases
Liver dysfunction
Metabolism
Mortality
Nutritional aspects
Patients
Physiology
Risk factors
Rodents
Sepsis
Variables
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Summary:The development of renal and liver dysfunction may be accompanied by initially subtle derangements in the gluconeogenetic function. Discrepantly low glucose levels combined with high lactate levels might indicate an impaired Cori cycle. Our objective was to examine the relation between early lactate and glucose levels with subsequent renal and liver dysfunction and hospital mortality in critically ill patients. Over a 4-year period (2011 to 2014), all adult patients admitted to our adult 48-bed teaching hospital intensive care unit (ICU) for at least 12 h were retrospectively analyzed. Lactate and glucose were regularly measured with point-of-care analyzers in all ICU patients. Lactate and glucose measurements were collected from 6 h before to 24 h after ICU admission. Patients with fewer than four lactate/glucose measurements were excluded. Patients received insulin according to a computer-guided control algorithm that aimed at a glucose level 2.3 mmol/L) and glucose quintiles (≤7.0; 7.0-7.6; 7.6-8.2; 8.2-9.0; >9.0 mmol/L) were related with outcome in univariate analysis (p 
ISSN:1364-8535
1466-609X
1364-8535
1366-609X
DOI:10.1186/s13054-017-1785-z