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Plasma lactate concentrations in septic peritonitis: A retrospective study of 83 dogs (2007–2012)
Author(s) -
Cortellini Stefano,
Seth Mayank,
KellettGregory Lindsay M.
Publication year - 2014
Publication title -
journal of veterinary emergency and critical care
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.886
H-Index - 47
eISSN - 1476-4431
pISSN - 1479-3261
DOI - 10.1111/vec.12234
Subject(s) - hyperlactatemia , medicine , peritonitis , retrospective cohort study , gastroenterology
Objective To determine if absolute plasma lactate concentration or lactate clearance in dogs with septic peritonitis is associated with morbidity or mortality. Design Retrospective cohort study from 2007 to 2012. Setting University teaching hospital. Animals Eighty‐three dogs with septic peritonitis were included. Patients had at least 1 plasma lactate measurement during the course of the hospitalization. Results Sixty‐four percent of the patients survived to discharge, 22% were euthanized, and 14% died during hospitalization. Plasma lactate concentration >2.5 mmol/L on admission (29% of the patients) was associated with mortality ( P = 0.001). Median admission plasma lactate concentration ( n = 81) was significantly different between nonsurvivors (2.5 mmol/L, range 0.5–8.4) and survivors (1.4 mmol/L, range 0.5–9.7; P = 0.007). Admission plasma lactate concentration >4 mmol/L yielded a sensitivity of 36% and a specificity of 92% for nonsurvival. The inability to normalize plasma lactate concentration within 6 hours of admission ( n = 10/24) yielded a sensitivity of 76% and specificity of 100% for nonsurvival. Postoperative hyperlactatemia (plasma lactate concentration >2 mmol/L; n = 18/76) had a sensitivity of 46% and specificity of 88% for nonsurvival. Persistent postoperative hyperlactatemia ( n = 11/18) had a sensitivity of 92% and a specificity of 100% for nonsurvival. Lactate clearance less than 21% at 6 hours ( n = 20) had a sensitivity of 54% and specificity of 91% for nonsurvival. Lactate clearance less than 42% at 12 hours ( n = 18) had a sensitivity of 82% and a specificity of 100% for nonsurvival. Conclusions Admission plasma lactate concentration and lactate clearance were good prognostic indicators in dogs with septic peritonitis.