Plasma lactate concentrations in septic peritonitis: A retrospective study of 83 dogs (2007-2012)

J Vet Emerg Crit Care (San Antonio). 2015 May-Jun;25(3):388-95. doi: 10.1111/vec.12234. Epub 2014 Sep 11.

Abstract

Objective: To determine if absolute plasma lactate concentration or lactate clearance in dogs with septic peritonitis is associated with morbidity or mortality.

Design: Retrospective cohort study from 2007 to 2012.

Setting: University teaching hospital.

Animals: Eighty-three dogs with septic peritonitis were included. Patients had at least 1 plasma lactate measurement during the course of the hospitalization.

Results: Sixty-four percent of the patients survived to discharge, 22% were euthanized, and 14% died during hospitalization. Plasma lactate concentration >2.5 mmol/L on admission (29% of the patients) was associated with mortality (P = 0.001). Median admission plasma lactate concentration (n = 81) was significantly different between nonsurvivors (2.5 mmol/L, range 0.5-8.4) and survivors (1.4 mmol/L, range 0.5-9.7; P = 0.007). Admission plasma lactate concentration >4 mmol/L yielded a sensitivity of 36% and a specificity of 92% for nonsurvival. The inability to normalize plasma lactate concentration within 6 hours of admission (n = 10/24) yielded a sensitivity of 76% and specificity of 100% for nonsurvival. Postoperative hyperlactatemia (plasma lactate concentration >2 mmol/L; n = 18/76) had a sensitivity of 46% and specificity of 88% for nonsurvival. Persistent postoperative hyperlactatemia (n = 11/18) had a sensitivity of 92% and a specificity of 100% for nonsurvival. Lactate clearance less than 21% at 6 hours (n = 20) had a sensitivity of 54% and specificity of 91% for nonsurvival. Lactate clearance less than 42% at 12 hours (n = 18) had a sensitivity of 82% and a specificity of 100% for nonsurvival.

Conclusions: Admission plasma lactate concentration and lactate clearance were good prognostic indicators in dogs with septic peritonitis.

Keywords: canine; lactime; outcome; sepsis; shock; survival.

Publication types

  • Evaluation Study

MeSH terms

  • Animals
  • Biomarkers / blood*
  • Cohort Studies
  • Critical Care
  • Dog Diseases / blood*
  • Dogs
  • Female
  • Lactic Acid / blood*
  • Male
  • Peritonitis / blood
  • Peritonitis / veterinary*
  • Postoperative Complications / blood
  • Postoperative Complications / veterinary*
  • Prognosis
  • Retrospective Studies
  • Sensitivity and Specificity
  • Shock, Septic / blood
  • Shock, Septic / veterinary*
  • Veterinary Medicine

Substances

  • Biomarkers
  • Lactic Acid