Peer-reviewed veterinary case report
How blood lactate and shock index predict survival in dogs with shock
By Zollo, Ann Marie et al.·Published in Journal of veterinary emergency and critical care (San Antonio, Tex. : 2001)·2019·Department of Emergency and Critical Care, United States·View original on PubMed →
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Original publication title: Utility of admission lactate concentration, lactate variables, and shock index in outcome assessment in dogs diagnosed with shock.
- Species:
- dog
Plain-English summary
A group of 23 dogs admitted to the ICU with shock showed varying outcomes based on their lactate levels and other measurements. The study found that dogs who survived had a shorter duration of elevated lactate levels and better lactate clearance over time compared to those who did not survive. While the initial lactate concentration didn't help predict survival, the changes in lactate levels over time did provide useful information. Overall, about 61% of the dogs survived to go home, highlighting the importance of monitoring lactate levels in critically ill dogs.
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Abstract
OBJECTIVE: To determine whether admission venous plasma lactate concentration, calculated lactate variables, or shock index (SI) could discriminate hospital survivors from nonsurvivors in dogs admitted with shock. DESIGN: Prospective investigation performed over a 19-month period. SETTING: Large urban private teaching hospital. ANIMALS: Twenty-three dogs consecutively admitted to the ICU from January 2008 to July 2009 with initial peripheral venous plasma lactate concentration >2 mmol/L (18.0 mg/dL) and clinical and hemodynamic parameters consistent with shock. INTERVENTIONS: None. MEASUREMENTS AND MAIN RESULTS: Heart rate, systolic blood pressure, and venous plasma lactate concentrations were serially recorded at predefined time points and used to calculate SI (SI = heart rate/systolic blood pressure) and lactate variables, including lactime (time lactate > 2.0 mmol/L), lactate clearance ([lactate- lactate]/lactate× 100), and LAC(area under the lactate concentration versus time curve). Primary outcome was survival to discharge. Overall survival rate was 61%. Admission venous plasma lactate concentration did not differ between groups (P = 0.2). Lactime was shorter in survivors versus nonsurvivors (P = 0.02). Lactate clearance at 1, 10, 16, 24, and 36 hours, and final lactate clearance were greater in survivors versus nonsurvivors (P < 0.05). LACat time intervals 0-1, 1-4, 4-10, 10-16, 16-24, 24-30, and 30-36 hours was larger in nonsurvivors versus survivors (P < 0.05). Total LACdid not differ between groups (P = 0.09). Admission SI and time to normalize SI (SI < 0.9) were not different between survivors and nonsurvivors (P > 0.05). CONCLUSIONS: While admission venous plasma lactate concentration could not discriminate between hospital survivors and nonsurvivors, lactate variables showed clinical utility to predict outcome in dogs with shock. Further studies are needed to determine SI reference ranges and optimal SI cut-off values to improve its prognostic ability in sick dogs.
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Search related cases →Original publication on PubMed: https://pubmed.ncbi.nlm.nih.gov/31290240/