Background
Methods
Results
First author, year [reference] | Number of patients | Study design | Initial minimum lactate for patient inclusion | Timing of measurements | Suggested time interval | Comments | |
---|---|---|---|---|---|---|---|
General ICU/emergency department | |||||||
Observational
| |||||||
1. | Vincent, 1983 [12] | 17 | Prospective | ≥4 | Every 20 min during first 2 h of ICU treatment | 1 h | Decrease >10 % associated with survival |
2. | Cowan, 1984 [23] | 30 | Prospective | – | 3 h, 24 h | 3 h | Change in lactate predictive of outcome but less so than simple hemodynamic variables |
3. | Suistomaa, 2000 [24] | 100 | Prospective | – | Every 2 h for 24 h | 6 h | Failure to decrease lactate at 6 h associated with higher mortality |
4. | Jansen, 2008 [31] | 106 | Prospective | – | Variable (at ambulance pickup and at ER arrival) | — | Decrease in lactate independently associated with decreased hazard of death |
5. | Wang, 2009 [25] | 101 | NR | ≥2 | 12 h, 24 h | 12 h | Decrease ≤10 % associated with increased mortality |
6. | Jansen, 2009 [26] | 394 | Prospective | – | 12 h, 24 h | 12 h | Decrease in lactate only of prognostic value in patients with sepsis |
7. | Krishna, 2009 [27] | 50 | Prospective | – | 12 h, 24 h, 36 h | 24 h, 36 h | Decreasing levels associated with survival |
8. | Soliman, 2010 [28] | 433 | Prospective | – | 24 h, 48 h | 24 h | Higher lactate concentrations at 24 and 48 h after admission associated with decreased survival |
9. | Nichol, 2010 [6] | 7155 | Retrospective | – | Variable | 24 h | Time-weighted average lactate over 24 h independent predictor of mortality |
10. | Nichol, 2011 [10] | 5041 | Retrospective | – | Variable | 24 h | Time-weighted average lactate and change in lactate over 24 h independent predictors of hospital mortality |
11. | van Beest, 2013 [29] | 2251 | Retrospective | – | Variable | 6 h | Normalization of lactate <6 h after ICU admission associated with better hospital survival than normalization of lactate >6 hrs |
12. | Zhang, 2014 [30] | 6291 | Retrospective | >2 | Variable | Variable | Normalization and speed of normalization related to outcome |
13. | Haas, 2016 [11] | 400 | Retrospective | >10 | Variable | 12 h | No decrease in lactate over 12 h associated with increased mortality |
Interventional
| |||||||
14. | Jansen, 2010 [15] | 348 | Prospective | ≥3.0 | 2 h | 8 h | Objective was to decrease lactate by 20 % or more per 2 h for the initial 8 h of ICU stay. Lactate-guided therapy was independently associated with reduced hospital mortality |
Surgical ICU | |||||||
15. | McNelis, 2001 [32] | 95 | Retrospective | – | 8-h intervals until lactate normalized | Variable | Time to lactate normalization predictive of outcome |
16. | Husain, 2003 [33] | 137 | Retrospective | – | Variable | Variable | Time to lactate normalization independent predictor of mortality |
17. | Meregalli, 2004 [34] | 44 | Prospective | – | 12 h, 24 h, 48 h | 48 h | Blood lactate concentrations decreased with time in survivors, but remained stable in nonsurvivors |
18. | Cardinal Fernandez, 2009 [35] | 108 | Prospective | >2 | 6 h | 6 h | Decrease in lactate by >40 % associated with increased survival |
19. | Ibrahim, 2013 [36] | 322 | Prospective | – | 8 h, 16 h, 24 h | 16 h | Percent change in blood lactate at 16 h independent predictor of postoperative mortality |
Cardiac surgery | |||||||
20. | Lindsay, 2013 [37] | 1291 | Retrospective | – | Variable | Variable | Longer predicted time to reach normal lactate (<1.5 mmol/l) associated with increased mortality |
21. | Hajjar, 2013 [38] | 502 | Prospective | – | 6 h, 12 h | 6 h, 12 h | Failure to decrease lactate associated with major complications, including death |
22. | Park, 2014 [39] | 115 | Retrospective | – | 6 h, 12 h, 24 h | 6 h, 12 h, 24 h | Lack of decrease in lactate predictive of mortality |
23. | Lopez-Delgado, 2015 [40] | 2935 | Prospective | – | 6 h, 12 h, 24 h | 24 h | Later peak in lactate associated with higher hospital and long-term mortality |
24. | Li, 2015 [41] | 123 | Retrospective | – | 6 h, 12 h | 12 h | Lactate decrease predictive of in-hospital mortality in patients receiving ECMO |
Trauma | |||||||
Observational
| |||||||
25. | Abramson, 1993 [42] | 76 | Prospective | – | 8 h, 16 h, 24 h, 36 h, 48 h | 24 h | Normalization of lactate by 24 h associated with 100 % survival |
26. | Manikis, 1995 [43] | 129 | Retrospective | – | At least three times a day | Variable | Duration of hyperlactatemia correlated with the development of organ failure but not with mortality |
27. | Holm, 2000 [44] | 21 | Prospective | – | 12 h, 24 h, 48 h, 72 h | Variable | Decreasing lactate levels associated with survival |
28. | Cerovic, 2003 [45] | 98 | Prospective | – | Twice daily during first 2 days and once daily during next 3 days | Variable | Reduced lactate levels in survivors |
29. | Kamolz, 2005 [46] | 166 | Prospective | – | Variable | 24 h | Higher mortality in patients with initial lactate > 2 mmol/l if lactate not normalized at 24 h |
30. | Billeter, 2009 [47] | 1032 | Retrospective | – | Variable | 24 h | Delayed or absent decrease in lactate associated with infectious complications but not mortality |
31. | Regnier, 2012 [48] | 281 | Prospective | – | 2 h, 4 h | 2 h | Early normalization of lactate independent predictor of survival |
32. | Dubendorfer, 2013 [49] | 724 | Retrospective | – | Variable | Variable | In patients without traumatic brain injury, decrease in lactate impaired in nonsurvivors |
33. | Odom, 2013 [50] | 623 | Retrospective | ≥4 | 6 h | 6 h | Lower decrease in lactate at 6 h independently predictive of increased risk of death |
34. | Heinonen, 2014 [51] | 610 | Retrospective | – | Variable | Variable | Failure to normalize lactate associated with increased mortality |
35. | Freitas, 2015 [52] | 117 | Retrospective | – | 6 h | 6 h | No correlation between decrease in lactate and mortality |
36. | Dezman, 2015 [53] | 3887 | Retrospective | ≥3 | Variable | Variable | No decrease in lactate independent predictor of 24-h mortality |
Interventional
| |||||||
37. | Blow, 1999 [55] | 79 | Retrospective | – | Variable | 24 h | Failure to decrease lactate associated with increased mortality |
38. | Claridge, 2000 [56] | 364 | Prospective | – | Variable | 12 h | Increase in infections, length of stay, and mortality if lactate did not normalize by 12 h |
Sepsis | |||||||
Observational
| |||||||
39. | Bakker, 1991 [57] | 48 | Prospective | >2 | Variable | Variable | Only survivors had a significant decrease in blood lactate concentrations during the course of septic shock |
40. | Friedman, 1995 [58] | 35 | Prospective | >2 | 4 h, 24 h | Variable | Lactate remained high in nonsurvivors and progressively decreased in survivors |
41. | Bernardin, 1996 [59] | 32 | Prospective | – | 24 h | 24 h | Greater decrease in lactate in survivors |
42. | Marecaux, 1996 [60] | 38 | Prospective | >2 | 24 h, 48 h | 24 h, 48 h | Greater decrease in lactate in survivors |
43. | Bakker, 1996 [61] | 87 | Prospective | >2 | Variable | Variable | Duration of lactic acidosis best discriminant of survival |
44. | Kobayashi, 2001 [62] | 22 | Prospective | – | Every 4 hours for 4 days | Variable | Decrease in lactate associated with survival |
45. | Nguyen, 2004 [63] | 111 | Prospective | – | 6 h | 6 h | Decrease in lactate ≥10 % associated with lower 60-day mortality |
46. | Nguyen, 2007 [64] | 330 | Prospective | – | Variable | 6 h | Decreased odds ratio for mortality in patients with decreased lactate |
47. | Phua, 2008 [65] | 72 | Prospective | – | 24 h, 48 h | 24 h | Increase in lactate predictive of mortality |
48. | Yang, 2009 [66] | 105 | Prospective | – | 6 h, 24 h, 72 h | 6 h | Decrease in lactate at 6 h ≥30 % was independent predictor of survival |
49. | Arnold, 2009 [67] | 166 | Retrospective | – | 6 h | 6 h | Lactate decrease by less than 10 % independent predictor of in-hospital death |
50. | Nguyen, 2010 [68] | 220 | Retrospective | – | 6 h | 6 h | Larger decrease in lactate associated with decreased mortality up to 12 months |
51. | Nguyen, 2011 [18] | 556 | Prospective | – | 12 h | 12 h | Any decrease in lactate within 12 h from baseline or an initial lactate <2 mmol/l independently associated with reduced mortality |
52. | Puskarich, 2012 [69] | 203 | Retrospective analysis of data from [16] | – | 2 h, 4 h, 6 h | 6 h | ≥10 % decrease in lactate during resuscitation associated with decreased mortality |
53. | Zanaty, 2012 [70] | 53 | Prospective | – | 6 h | 6 h | <15 % decrease in lactate independent predictor of mortality |
54. | Puskarich, 2013 [71] | 187 | Retrospective analysis of data from [16] | – | At least two lactate measurements in first 6 h | 6 h | Lactate normalization in 6 h stronger independent predictor of survival than decrease in lactate by ≥50 % |
55. | Walker, 2013 [72] | 78 | Retrospective | – | 6 h | 6 h | Decrease in lactate independently associated with mortality, with optimal cut-off of 36 % |
56. | Liu, 2013 [73] | 9190 | Retrospective | ≥2 | 4 h, 8 h, 12 h | 12 h | Reduced mortality in patients with more than 60 % lactate improvement at 12 h. |
57. | Marty, 2013 [74] | 94 | Prospective | – | 6 h, 12 h, 24 h | 24 h | Decrease in lactate at 24 h independently correlated to survival |
58. | Park, 2014 [75] | 25 | Prospective | – | 6 h, 12 h, 18 h, 24 h, 48 h | 48 h | Normalization independent predictor of survival |
59. | Permpikul, 2014 [76] | 51 | Prospective | – | 6 h | 6 h | Lactate decrease associated with reduced 28-day mortality |
60. | Bao, 2015 [77] | 94 | Retrospective | – | 3 h, 6 h, 24 h | 24 h | 24-h lactate decrease predictive of outcome |
61. | Galbois, 2015 [78] | 42 | Prospective | – | 6 h, 12 h, 18 h, 24 h | 6 h | Lesser decrease in lactate associated with 14-day mortality |
62. | Lee, 2015 [79] | 109 | Retrospective | >3.3 | 6 h, 24 h, 48 h | 6 h, 24 h, 48 h | Decrease in lactate of <10 % in the first 6 h, 24 h, and 48 h independently associated with mortality |
63. | Dettmer, 2015 [17] | 243 | Retrospective | ≥4 | Variable | Variable | Greater reduction in lactate associated with decreased 28-day mortality |
64. | Lokhandwala, 2015 [80] | 74 | Retrospective | ≥4 | Variable | Variable | Lactate decrease < 4 mmol/l associated with increased hospital morality |
65. | Wang, 2015 [81] | 115 | Prospective | – | 6 h, 12 h, 18 h, 24 h | 24 h | Lower lactate area score and percentage decrease in lactate associated with increased mortality |
66. | Bhat, 2015 [82] | 207 | Retrospective | – | Variable | Variable | Higher mortality in patients with no decrease in lactate |
67. | Chertoff, 2016 [83] | 229 | Retrospective | – | 24-48 h | 24-48 h | Lower decrease in plasma lactate 24–48 h after initiation of treatment was associated with higher 30-day mortality |
68. | Drumheller, 2016 [84] | 411 | Retrospective | ≥4 | Variable | Variable | Decrease in lactate independently associated with decreased risk of death |
69. | He, 2016 [85] | 84 | Prospective | – | 8 h | 8 h | Patients with lactate decrease ≥10 % had lower ICU mortality than those with lactate decrease <10 % |
70. | Ha, 2016 [86] | 208 | – | 6 h, 24 h | 24 h | Low decrease in lactate at 6 and 24 h independently associated with hospital mortality, but 24-h lactate decrease had higher discriminatory power | |
71. | Bolvardi, 2016 [87] | 90 | Prospective | – | 6 h | 6 h | Lactate decrease <10 % associated with increased mortality |
72. | Amir, 2016 [88] | 202 | Prospective | – | 6 h | 6 h | Lactate decrease ≥10 % not associated with mortality |
Interventional
| |||||||
73. | Jones, 2010 [16] | 300 | Prospective | – | Variable | Variable | No differences in in-hospital mortality using management to normalize lactate compared with management to normalize ScvO2
|
74. | Tian, 2012 [89] | 62 | Prospective | – | Variable | 48 h | 28-day mortality rates lower in patients with 30 % decrease in lactate target than in those with 10 % decrease in lactate target and controls |
75. | Yu, 2013 [90] | 50 | Prospective | – | 3 h, 6 h, 72 h | 6 h, 72 h | No differences in in-hospital mortality using management targeted at 10 % lactate decrease compared with management to normalize ScvO2
|
76. | Lyu, 2015 [91] | 100 | Prospective | – | 1 h, 2 h, 3 h, 4 h, 5 h, 6 h | 6 h | 28-day mortality independently associated with lactate decrease <10 % |
77. | Kuan, 2016 [92] | 122 | Prospective | ≥3 | Variable | 3 h | Lactate decrease >20 % associated with decreased mortality |
Cardiogenic shock | |||||||
78. | Attana, 2012 [93] | 51 | Prospective | – | 12 h | 12 h | Decrease in lactate by <10 % predicts higher risk of death |
79. | Attana, 2013 [94] | 63 | Prospective | – | 12 h | 12 h | Nonsurvivors had smaller decrease in lactate |
80. | Park, 2014 [95] | 96 | Retrospective | – | Variable | 48 h | Lactate decrease <70 % independent predictor of hospital mortality |
81. | Guenther, 2014 [96] | 41 | retrospective | – | Variable | 6 h | Increased lactate concentrations at 6 h associated with nonsurvival after ECMO |
Cardiac arrest | |||||||
82. | Kliegel, 2004 [97] | 394 | Retrospective | – | 24 h, 48 h | 48 h | Persistent hyperlactatemia predictive or poor prognosis |
83. | Donnino, 2007 [98] | 79 | Retrospective | – | 6 h, 12 h | 12 h | Decrease in lactate independent predictor of hospital survival |
84. | Arnalich, 2010 [99] | 85 | Prospective | – | 6 h | 6 h | Decrease in lactate significantly higher in 24-h survivors compared with nonsurvivors |
85. | Le Guen, 2011 [100] | 51 | Prospective | – | 1 h | 1 h | Decrease in blood lactate >10 % significantly different in survivors and nonsurvivors treated with ECMO |
86. | Starodub, 2013 [101] | 199 | Retrospective | – | 6 h, 12 h, 24 h | 12 h, 24 h | Change in lactate over time not predictive of survival but lower mean lactate levels at 12 and 24 h associated with increased survival |
87. | Donnino, 2014 [102] | 100 | Prospective | – | 12 h, 24 h | 12 h | Greater percentage decrease independently associated with survival |
88. | Riveiro, 2015 [103] | 54 | Prospective | – | 6 h, 12 h, 24 h, 48 h, 72 h | 6 h | Decrease in lactate predictive of 28-day survival |
89. | Williams, 2016 [104] | 167 | Retrospective | – | Variable | 4 h | More rapid decrease in lactate in survivors |
Respiratory failure | |||||||
90. | Zhao, 2010 [105] | 110 | Prospective | – | 6 h | 6 h | Lactate decrease ≥10 % associated with improved survival |
91. | Wu, 2012 [106] | 27 | Prospective | – | 12 h, 24 h, 48 h, 72 h | 12 h, 24 h, 48 h, 72 h | Smaller decrease in lactate predictive of outcome |
92. | Zang, 2014 [107] | 43 | Prospective | – | 6 h | 6 h | Decrease in lactate independent predictor of survival in patients treated by ECMO |
Others | |||||||
93. | Scott, 2010 [110] | 95 | Prospective | – | 1 h, 2 h, 6 h, 24 h | 2 h | Lactate decrease <15 % predictive of poor outcome (hospital mortality or endotracheal intubation) in patients with cardiorespiratory insufficiency |
94. | Wu, 2011 [109] | 222 | Prospective | – | 6 h | 6 h | Lactate decrease of <24.8 % at 6 h associated with higher incidence of liver graft failure and mortality |
95. | Lui, 2013 [108] | 204 | Prospective | ≥2 | 12 h | 12 h | Smaller decrease in lactate associated with increased mortality in patients with paraquat poisoning |
96. | Mohamed, 2014 [111] | 46 | Prospective | – | 8 h, 24 h | 24 h | Mortality greater if <40 % decrease in lactate |