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Sepsis is defined as SIRS in response to an infectious process. [48] Severe sepsis is defined as sepsis with sepsis-induced organ dysfunction or tissue hypoperfusion (manifesting as hypotension, elevated lactate, or decreased urine output). Severe sepsis is an infectious disease state associated with multiple organ dysfunction syndrome (MODS) [9]
Lactic acidosis refers to the process leading to the production of lactate by anaerobic metabolism. It increases hydrogen ion concentration tending to the state of acidemia or low pH. The result can be detected with high levels of lactate and low levels of bicarbonate. This is usually considered the result of illness but also results from ...
The SOFA scoring system is useful in predicting the clinical outcomes of critically ill patients. [8] According to an observational study at an Intensive Care Unit (ICU) in Belgium, the mortality rate is at least 50% when the score is increased, regardless of initial score, in the first 96 hours of admission, 27% to 35% if the score remains unchanged, and less than 27% if the score is reduced. [9]
Patients with septic shock can be clinically identified by requiring a vasopressor to maintain a mean arterial pressure of 65 mm Hg or greater and having serum lactate level greater than 2 mmol/L (>18 mg/dL) in the absence of hypovolemia. This combination is associated with hospital mortality rates greater than 40%. [1]
Lactate - rising lactate in the blood indicates that areas of the body are not getting enough oxygen [11] Cultures - blood cultures and source-specific cultures (urine, sputum, etc.) should be collected when septic shock is suspected in order to identify and source and target treatment [11]
Anaerobic glycolysis is the transformation of glucose to lactate when limited amounts of oxygen (O 2) are available. [1] This occurs in health as in exercising and in disease as in sepsis and hemorrhagic shock. [1] providing energy for a period ranging from 10 seconds to 2 minutes.
Blood tests for lactate are performed to determine the status of the acid base homeostasis in the body. Blood sampling for this purpose is often arterial (even if it is more difficult than venipuncture), because lactate levels differ substantially between arterial and venous, and the arterial level is more representative for this purpose.
White blood cells and blood lactate levels may also be elevated, particularly in the case of advanced disease including peritonitis and sepsis. [20] Differential diagnoses of gastrointestinal perforation includes other causes of an acute abdomen, including appendicitis, diverticulitis, ruptured ovarian cyst, or pancreatitis. [21]