Definition of clinically relevant lactic acidosis in patients with internal diseases

In order to define clinically relevant lactic acidosis, 12 biochemical variables, eight clinical symptoms and signs, leading diagnoses, and mortality were evaluated prospectively in approximately 2,000 unselected patients with internal diseases, consecutively admitted to the hospital. Patients with...

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Bibliographic Details
Published inAmerican journal of clinical pathology Vol. 80; no. 4; pp. 484 - 489
Main Authors LUFT, D, DEICHSEL, G, SCHMULLING, R.-M, STEIN, W, EGGSTEIN, M
Format Journal Article
LanguageEnglish
Published Chicago, IL American Society of Clinical Pathologists 01.10.1983
Subjects
Acidosis - diagnosis
Acidosis - epidemiology
Acidosis - etiology
Analysis of Variance
Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy
Biological and medical sciences
Emergency and intensive care: injuries, diseases due to physical agents. Diving. Drowning. Disaster medicine
Emergency and intensive care: metabolism and nutrition disorders. Enteral and parenteral nutrition
Germany, West
Heart Diseases - complications
Humans
Intensive care medicine
Lactates - blood
Lung Diseases - complications
Medical sciences
Patient Admission
Poisoning - complications
Prognosis
Germany, West
Hyperlactacidemia
Metabolic acidosis
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Summary:In order to define clinically relevant lactic acidosis, 12 biochemical variables, eight clinical symptoms and signs, leading diagnoses, and mortality were evaluated prospectively in approximately 2,000 unselected patients with internal diseases, consecutively admitted to the hospital. Patients with incomplete data sets were not considered. Of those patients who repeatedly were admitted to the hospital during the time of the study, only the first admission was included for statistical analysis. In addition to 11 definitions of lactic acidosis given in the literature, sequential cluster analyses of the biochemical variables were used to estimate the incidence of lactic acidosis in 1,467 patients. Depending upon which definition was used, 0.5-3.8% of all patients were classified as suffering from lactic acidosis, with a mortality rate ranging from 30-88%. From this study it is concluded that a limit of less than or equal to 7.35 for pH and of greater than 5-6 mmol/L for the concentration of lactate in whole blood will minimize false-negative or false-positive classifications.
ISSN:0002-9173
1943-7722
DOI:10.1093/ajcp/80.4.484