The Particulars: Outside of controlled clinical trials, little is known about the impact of lactate clearance on outcomes among patients in the ED and its association with therapeutic interventions.
Data Breakdown: For a study, adults with severe sepsis presenting to an urban academic ED were divided into those with lactate clearance greater than 10% (LC) and less than 10% (NC). Therapeutic interventions and resuscitation variables did not differ between the groups. However, the LC group had lower mortality (15% vs 59%), more ventilator-free days (22.1 vs 13.5), and more vasopressor-free days (22.9 vs. 14.1).
Take Home Pearls: Poor lactate clearance among ED patients with severe sepsis appears to be associated with increased mortality and morbidity. However, therapeutic interventions appear to be similar in those with good and poor clearance.