lactic acid and Shock, Septic studies

Lactic Acid: A normal intermediate in the fermentation (oxidation, metabolism) of sugar. The concentrated form is used internally to prevent gastrointestinal fermentation. (From Stedman, 26th ed)
2-hydroxypropanoic acid : A 2-hydroxy monocarboxylic acid that is propanoic acid in which one of the alpha-hydrogens is replaced by a hydroxy group.

Shock, Septic: Sepsis associated with HYPOTENSION or hypoperfusion despite adequate fluid resuscitation. Perfusion abnormalities may include but are not limited to LACTIC ACIDOSIS; OLIGURIA; or acute alteration in mental status.

Research Excerpts

Excerpt	Relevance	Reference
" With serum lactate values > 10 mmol/l 80 % of the patients die in intensive care, and if the severe lactic acidosis persists for 48 hours, all patients die."	8.98	[Lactic acidosis - update 2018]. ( de Heer, G; Fuhrmann, V; Jarczak, D; Kluge, S; Nierhaus, A, 2018)
"In our data, preadmission metformin use is associated with a significantly larger decrease in lactate after admission with sepsis or septic shock and with reduced mortality in septic shock."	8.31	New potential for an old kid on the block: Impact of premorbid metformin use on lactate kinetics, kidney injury and mortality in sepsis and septic shock, an observational study. ( De Decker, K; De Neve, N; Tackaert, T; Van Moorter, N; Van Vlem, B, 2023)
"This study investigated the prognostic value of the albumin-to-fibrinogen ratio (AFR) in patients with sepsis as a consequence of infection at various sites."	8.12	Prognostic Value of Albumin-to-Fibrinogen Ratio for 28-Day Mortality among Patients with Sepsis from Various Infection Sites. ( Chang, B; Li, S; Shen, Y; Wang, N, 2022)
"Treatment of pediatric septic shock with thiamine was followed by rapid improvement in physiologic and clinical outcomes after prolonged hyperlactatemia."	7.91	Matched Retrospective Cohort Study of Thiamine to Treat Persistent Hyperlactatemia in Pediatric Septic Shock. ( Berg, RA; Blowey, B; Fitzgerald, JC; Ganetzky, R; Keele, L; Murali, CN; Sutton, RM; Weiss, SL, 2019)
"We aimed to evaluate the impact of metformin use on lactate kinetics in patients with severe sepsis and septic shock."	7.85	Impact of Metformin Use on Lactate Kinetics in Patients with Severe Sepsis and Septic Shock. ( Carriere, KC; Cha, WC; Hwang, SY; Jeon, K; Jo, IJ; Lee, TR; Park, J; Shin, TG; Sim, MS; Suh, GY; Yeon, S; Yoon, H, 2017)
"Compared with dobutamine, levosimendan increased intestinal blood flow and diminished intramucosal acidosis in this experimental model of sepsis."	7.74	Effects of levosimendan and dobutamine in experimental acute endotoxemia: a preliminary controlled study. ( Barán, M; Canales, HS; Dubin, A; Edul, VS; Estenssoro, E; Etcheverry, G; Maskin, B; Murias, G; Pozo, MO; Sottile, JP, 2007)
"This study demonstrates that exogenous ADM prevents and reverses hypodynamic circulation, attenuates pulmonary hypertension, and limits lactic acidosis in ovine endotoxaemia."	7.74	Exogenous adrenomedullin prevents and reverses hypodynamic circulation and pulmonary hypertension in ovine endotoxaemia. ( Booke, M; Ertmer, C; Hucklenbruch, C; Lange, M; Morelli, A; Rehberg, S; Van Aken, H; Westphal, M, 2007)
"Preconditioning pigs with low doses of monophosphoryl lipid A (MPL), a non toxic derivate of lipid A, has been shown to induce endotoxin hyporesponsiveness and to reduce the metabolic and hemodynamic consequences of endotoxin shock."	7.72	Tissue metabolism during endotoxin shock after pretreatment with monophosphoryl lipid A. ( Bahlmann, L; Gliemroth, J; Heringlake, M; Klaus, S; Schmucker, P; Staubach, KH, 2003)
" We compared the effects of vasopressin alone and in combination with dobutamine on systemic and splanchnic circulation and metabolism in porcine endotoxin shock."	7.72	Dobutamine compensates deleterious hemodynamic and metabolic effects of vasopressin in the splanchnic region in endotoxin shock. ( Martikainen, TJ; Ruokonen, E; Tenhunen, JJ; Uusaro, A, 2004)
"In septic shock, the extent to which lactic acidosis (LA) is a consequence of splanchnic lactate overproduction (SLP) or impaired hepatic lactate extraction (HLE) is not clear."	7.70	Impaired hepatic extraction and increased splanchnic production contribute to lactic acidosis in canine sepsis. ( Bands, C; Bautista, E; Bose, D; Chrusch, C; Duke, K; Eschun, G; Jacobs, H; Li, X; Light, RB; Mink, SN, 2000)
"The influence of pentoxifylline (PTX) on mortality and some important mediators was studied in a model of cecal perforation with fulminant intra-abdominal sepsis in rats."	7.69	Pentoxifylline improves survival and reduces tumor necrosis factor, interleukin-6, and endothelin-1 in fulminant intra-abdominal sepsis in rats. ( Ekstrøm, P; Giercksky, KE; Lundblad, R, 1995)
"In cases of Polytrauma induced sepsis or septic shock, the level started to increase within first 72 hours after traumatic injury, pick concentration was achieved within first 25 days high from the beginning and dynamically increases within first 25 days, the tendency of gradual decrease was seen after 30 days."	5.48	THE ROLE OF PROCALCITONIN AND BLOOD LACTIC ACID VALUES IN PROGNOSIS OF SEPSIS AND SEPTIC SHOCK IN POLYTRAUMA PATIENTS. ( Kanashvili, B; Ratiani, L; Saganelidze, K, 2018)
"To determine the effects on hemodynamics, laboratory parameters, and renal function of terlipressin used in septic-shock patients with hypotension not responsive to high-dose norepinephrine (>2."	5.11	Terlipressin in catecholamine-resistant septic shock patients. ( Albanèse, J; Chaabane, W; Delmas, A; Garnier, F; Leone, M; Martin, C, 2004)
" With serum lactate values > 10 mmol/l 80 % of the patients die in intensive care, and if the severe lactic acidosis persists for 48 hours, all patients die."	4.98	[Lactic acidosis - update 2018]. ( de Heer, G; Fuhrmann, V; Jarczak, D; Kluge, S; Nierhaus, A, 2018)
"In our data, preadmission metformin use is associated with a significantly larger decrease in lactate after admission with sepsis or septic shock and with reduced mortality in septic shock."	4.31	New potential for an old kid on the block: Impact of premorbid metformin use on lactate kinetics, kidney injury and mortality in sepsis and septic shock, an observational study. ( De Decker, K; De Neve, N; Tackaert, T; Van Moorter, N; Van Vlem, B, 2023)
"05) between two groups, which included birth weight (BW), weight on admission, gestational age, age on admission, mode of delivery, septic shock, heart failure, respiratory failure, pulmonary hypertension, hypothermia, serum lactic acid, and aspartate aminotransferase (AST)."	4.31	Risk factors for death caused by early onset sepsis in neonates: a retrospective cohort study. ( Chen, F; Chen, X; He, H; Hu, Y; Wei, H, 2023)
"This study investigated the prognostic value of the albumin-to-fibrinogen ratio (AFR) in patients with sepsis as a consequence of infection at various sites."	4.12	Prognostic Value of Albumin-to-Fibrinogen Ratio for 28-Day Mortality among Patients with Sepsis from Various Infection Sites. ( Chang, B; Li, S; Shen, Y; Wang, N, 2022)
"The authors design an animal model of neonatal sepsis to analyze the treatment of neonatal septic shock with Methylene Blue (MB) in a swine model."	4.12	Methylene Blue to Neonatal Septic Shock treatment in neonate pigs ( Albuquerque, AAS; de Castro, RSAP; Evora, PRB; Ferreira, CHF; Gonçalves-Ferri, WA; Oharomari, LK; Silva Lessa, DF, 2022)
"We evaluated the ability of four biomarkers (C-Reactive protein (CRP), lactate, mid-regional proadrenomedullin (MR-proADM) and procalcitonin (PCT)) to detect each kind of organ failure considered in the SOFA in 213 patients with infection, sepsis or septic shock, by using multivariate regression analysis and calculation of the area under the receiver operating curve (AUROC)."	3.96	MR- proADM to detect specific types of organ failure in infection. ( Aldecoa, C; Almansa, R; Andaluz-Ojeda, D; Andrés, C; Bermejo-Martin, JF; Calvo, D; Cicuendez, R; Esteban-Velasco, MC; Martín, S; Martin-Fernandez, M; Muñoz-Bellvís, L; Nogales, L; Ríos-Llorente, A; Sanchez-Barrado, E; Vaquero-Roncero, LM, 2020)
"Treatment of pediatric septic shock with thiamine was followed by rapid improvement in physiologic and clinical outcomes after prolonged hyperlactatemia."	3.91	Matched Retrospective Cohort Study of Thiamine to Treat Persistent Hyperlactatemia in Pediatric Septic Shock. ( Berg, RA; Blowey, B; Fitzgerald, JC; Ganetzky, R; Keele, L; Murali, CN; Sutton, RM; Weiss, SL, 2019)
"We aimed to evaluate the impact of metformin use on lactate kinetics in patients with severe sepsis and septic shock."	3.85	Impact of Metformin Use on Lactate Kinetics in Patients with Severe Sepsis and Septic Shock. ( Carriere, KC; Cha, WC; Hwang, SY; Jeon, K; Jo, IJ; Lee, TR; Park, J; Shin, TG; Sim, MS; Suh, GY; Yeon, S; Yoon, H, 2017)
"In 70 mechanically-ventilated patients with septic shock, we examined: a) S' and E' mitral annular velocities using tissue Doppler imaging (TDI), b) CFR of the left anterior descending artery after adenosine infusion using transesophageal Doppler echocardiography and c) lactate, pyruvate and glycerol in tissue by means of a microdialysis (MD) catheter inserted into the subcutaneous adipose tissue as markers of tissue ischemia and acidosis."	3.80	Coronary flow reserve is associated with tissue ischemia and is an additive predictor of intensive care unit mortality to traditional risk scores in septic shock. ( Armaganidis, A; Diamantakis, A; Dimopoulou, I; Ikonomidis, I; Kopterides, P; Lekakis, J; Makavos, G; Nikitas, N; Paraskevaidis, I; Parissis, J; Theodorakopoulou, M, 2014)
"Compared with dobutamine, levosimendan increased intestinal blood flow and diminished intramucosal acidosis in this experimental model of sepsis."	3.74	Effects of levosimendan and dobutamine in experimental acute endotoxemia: a preliminary controlled study. ( Barán, M; Canales, HS; Dubin, A; Edul, VS; Estenssoro, E; Etcheverry, G; Maskin, B; Murias, G; Pozo, MO; Sottile, JP, 2007)
"This study demonstrates that exogenous ADM prevents and reverses hypodynamic circulation, attenuates pulmonary hypertension, and limits lactic acidosis in ovine endotoxaemia."	3.74	Exogenous adrenomedullin prevents and reverses hypodynamic circulation and pulmonary hypertension in ovine endotoxaemia. ( Booke, M; Ertmer, C; Hucklenbruch, C; Lange, M; Morelli, A; Rehberg, S; Van Aken, H; Westphal, M, 2007)
"Preconditioning pigs with low doses of monophosphoryl lipid A (MPL), a non toxic derivate of lipid A, has been shown to induce endotoxin hyporesponsiveness and to reduce the metabolic and hemodynamic consequences of endotoxin shock."	3.72	Tissue metabolism during endotoxin shock after pretreatment with monophosphoryl lipid A. ( Bahlmann, L; Gliemroth, J; Heringlake, M; Klaus, S; Schmucker, P; Staubach, KH, 2003)
" aeruginosa, hepatic oxygen delivery and consumption increased with early sepsis whereas there were no alterations in the concentrations of adenine nucleotides or NAD(+)/NADH within liver."	3.72	Sepsis-induced failure of hepatic energy metabolism. ( Asimakis, GK; Chinkes, DL; Gore, DC; Hart, DW; Rinehart, AJ, 2003)
" We compared the effects of vasopressin alone and in combination with dobutamine on systemic and splanchnic circulation and metabolism in porcine endotoxin shock."	3.72	Dobutamine compensates deleterious hemodynamic and metabolic effects of vasopressin in the splanchnic region in endotoxin shock. ( Martikainen, TJ; Ruokonen, E; Tenhunen, JJ; Uusaro, A, 2004)
"Sixty consecutive adult patients who developed septic shock and lactic acidosis requiring the administration of vasopressors."	3.70	Evolution of lactate/pyruvate and arterial ketone body ratios in the early course of catecholamine-treated septic shock. ( Bollaert, PE; Gelot, AM; Larcan, A; Levy, B; Nabet, P; Sadoune, LO, 2000)
"In septic shock, the extent to which lactic acidosis (LA) is a consequence of splanchnic lactate overproduction (SLP) or impaired hepatic lactate extraction (HLE) is not clear."	3.70	Impaired hepatic extraction and increased splanchnic production contribute to lactic acidosis in canine sepsis. ( Bands, C; Bautista, E; Bose, D; Chrusch, C; Duke, K; Eschun, G; Jacobs, H; Li, X; Light, RB; Mink, SN, 2000)
" Parallel to these changes, systemic lactic acidosis developed."	3.69	Detection of liver ischemia using microdialysis during experimental peritonitis in pigs. ( Haglund, U; Hillered, L; Rasmussen, I; Ungerstedt, U, 1994)
"The influence of pentoxifylline (PTX) on mortality and some important mediators was studied in a model of cecal perforation with fulminant intra-abdominal sepsis in rats."	3.69	Pentoxifylline improves survival and reduces tumor necrosis factor, interleukin-6, and endothelin-1 in fulminant intra-abdominal sepsis in rats. ( Ekstrøm, P; Giercksky, KE; Lundblad, R, 1995)
" We studied the effects of anti-inflammatory drugs, indomethacin (IND) and dexamethasone (DX), on glucoregulation, body weight, and mortality in 10-day-old suckling rats administered Salmonella enteritidis lipopolysaccharide (LPS)."	3.68	Dexamethasone and indomethacin treatment during endotoxicosis in the suckling rat. ( Goto, M; Hurley, RM; Zeller, WP, 1990)
"Since oxygen free radicals may have a role in the pathophysiology of endotoxin shock, we have studied the effects of a wide range of compounds (alpha-tocopherol, reduced glutathione, allopurinol, superoxide dismutase (alone or in combination with catalase) and phenyl butylnitrone) that can act either to remove free radicals as they are generated or to prevent their generation."	3.67	Modification by oxygen free radical scavengers of the metabolic and cardiovascular effects of endotoxin infusion in conscious rats. ( Furman, BL; McKechnie, K; Parratt, JR, 1986)
"Sepsis was induced by fecal peritonitis."	3.30	Neutralization of extracellular histones by sodium-Β-O-methyl cellobioside sulfate in septic shock. ( Annoni, F; Creteur, J; Dewachter, L; Eycken, MV; Favory, R; Garcia, B; Herpain, A; Khaldi, A; Li, N; Manicone, F; Moiroux-Sahraoui, A; Moreau, A; Remmelink, M; Shi, L; Su, F; Taccone, FS; Vincent, JL; Wang, Y, 2023)
"Eligible septic shock patients who consented to participation in the study were randomly assigned to receive early lactate-guided treatment or regular treatment as controls."	3.11	Early Lactate-Guided Resuscitation of Elderly Septic Patients. ( Chen, H; Tong, F; Wang, X; Wang, Y; Xu, J, 2022)
"For children with septic shock who do not reach the 6-hour initial recovery target and/or have a fluid overload of >10%, early CBP treatment can quickly control the disease, shorten the course of disease, and accelerate immune reconstruction."	2.94	[Effect of early continuous blood purification on the prognosis of children with septic shock: a prospective randomized controlled clinical trial]. ( Li, Z; Lu, GZ; Mo, WG; Mo, ZR; Tang, YP; Wei, R; Wei, Y; Xie, YJ, 2020)
"We evaluated 44 patients with septic shock in the study group and 20 stable postoperative patients in the control group."	2.94	Association Between Doppler Snuffbox Resistive Index and Tissue Perfusion in Septic Patients. ( Huang, W; Liu, D; Su, L; Wang, C; Wang, X; Zhang, H, 2020)
"The most frequent indications were low blood pressure/increase in noradrenalin dose (199 boluses, 78%), high lactate (94, 37%), and low urinary output (68, 27%)."	2.90	Indications for fluid resuscitation in patients with septic shock: Post-hoc analyses of the CLASSIC trial. ( Bjerregaard, MR; Hjortrup, PB; Perner, A, 2019)
"Abnormal peripheral perfusion after septic shock resuscitation has been associated with organ dysfunction and mortality."	2.90	Effect of a Resuscitation Strategy Targeting Peripheral Perfusion Status vs Serum Lactate Levels on 28-Day Mortality Among Patients With Septic Shock: The ANDROMEDA-SHOCK Randomized Clinical Trial. ( Aldana, JL; Alegría, L; Alvarez, I; Aquevedo, A; Aramburu, MJ; Arancibia, JM; Aravena, F; Atehortua, H; Bakker, J; Barahona, D; Barberán, JL; Barzallo, E; Bejarano, A; Berrutti, D; Bettini, L; Bozinovic, M; Bravo, S; Bustamante, LA; Cadena Zapata, M; Calahorrano, J; Calderón, A; Calderón, LE; Caminos, F; Campassi, L; Canales, H; Candia, E; Carmona, C; Carpio, D; Castro, R; Cavalcanti, AB; Ceballos, C; Cecconi, M; Cid, MA; Cobos, P; Cook, D; Cortés, C; Damiani, LP; Dávila, H; Delgado, G; Dellinger, P; Dreyse, J; Dubin, A; Escobar, E; Espinosa, E; Estenssoro, E; Esveile, C; Fasce, F; Fernández, P; Ferri, G; Friedman, G; Furche, M; Gallardo, D; Galletti, C; Garcés, P; García, F; Gaudín, A; Gomez, L; González, H; González, MC; Granda, V; Granda-Luna, V; Guerrero, F; Henriquez, E; Hernán Portilla, A; Hernández, G; Herrera, L; Holger, P; Horna, N; Hurtado, J; Jibaja, M; Jimenez, J; Kavanagh, BP; Lacuesta, P; Lara, A; Larroulet, M; Lastra, J; López, A; Lopez, M; Lovesio, C; Luengo, C; Medel, N; Mendoza, D; Minoldo, E; Mora, JA; Moreira, J; Moya, T; Muñoz, A; Muñoz, P; Nahuelpán, B; Nin, N; Ochoa, M; Olivera, G; Olmos, D; Orazabal, MA; Ornes, A; Ortiz, G; Ospina-Tascón, G; Ospina-Tascón, GA; Oviedo, V; Pairumani, R; Pais, R; Pardo Espejo, R; Paredes, F; Paredes, G; Pavéz, N; Pendino, JC; Peréz, V; Petri Damiani, L; Petruska, E; Picoita, F; Ponce, D; Pozo, M; Quiroga, C; Ramirez, G; Ramirez, M; Ramirez, V; Remache, N; Rhodes, A; Rieppi, G; Rietdijk, W; Rodriguez, N; Rodruguez, J; Rossel, V; Rubatto, P; Sabogal, R; Salazar, S; Salcedo, B; Sanchez, A; Sanchez, F; Sanchez, JE; Sarabia, C; Silvestre, A; Solis, F; Soto, N; Suing, J; Tana, C; Teboul, JL; Tenzi, J; Tobar, M; Toctaquiza, G; Torres, G; Torres, P; Valenzuela, ED; Valle, F; Vera, M; Villacres, I; Vincent, JL; Vintimilla, F; Zambrano, F, 2019)
"Adult patients with septic shock under ventilation were randomized to receive sedation strategy with or without dexmedetomidine (60 in the dexmedetomidine and 51 in the nondexmedetomidine groups)."	2.87	Effect of Dexmedetomidine on Lactate Clearance in Patients With Septic Shock: A Subanalysis of a Multicenter Randomized Controlled Trial. ( Kato, S; Kawazoe, Y; Miyamoto, K; Morimoto, T; Nakashima, T; Ohta, Y; Shima, N; Ueda, K; Yamamura, H, 2018)
"Patients with septic shock with lactate greater than 2 mmol/L or less than or equal to 2 mmol/L, randomized to vasopressin or norepinephrine."	2.84	The Septic Shock 3.0 Definition and Trials: A Vasopressin and Septic Shock Trial Experience. ( Boyd, JH; Lee, T; Russell, JA; Singer, J; Walley, KR, 2017)
"Cirrhotics with septic shock underwent open label randomization to receive either terlipressin (n=42) or noradrenaline (n=42) infusion at a titrated dose."	2.84	A randomized trial comparing terlipressin and noradrenaline in patients with cirrhosis and septic shock. ( Bhadoria, AS; Choudhury, A; Joshi, YK; Kedarisetty, CK; Kumar, G; Kumar, S; Maiwall, R; Saini, D; Sarin, SK; Sharma, MK; Vashishtha, C, 2017)
"At both 6- and 24-hour measurements, the fluid volume was lower and norepinephrine dosage was higher in the control group than in the study group (P < ."	2.84	Global end-diastolic volume index vs CVP goal-directed fluid resuscitation for COPD patients with septic shock: a randomized controlled trial. ( Chen, Q; Lin, H; Shao, J; Wang, D; Yu, J; Zheng, R, 2017)
"The Protocol-based Care for Early Septic Shock trial found no differences across alternative resuscitation strategies in all-cause mortality."	2.84	Relationship Between Alternative Resuscitation Strategies, Host Response and Injury Biomarkers, and Outcome in Septic Shock: Analysis of the Protocol-Based Care for Early Septic Shock Study. ( Angus, DC; Huang, DT; Kellum, JA; Pike, F; Shapiro, NI; Yealy, DM, 2017)
"Septic shock is characterized by hypotension requiring vasopressors after adequate fluid resuscitation with elevated lactate."	2.82	Sepsis Management for the Nephrologist. ( Dellinger, RP; Patel, S; Puri, N, 2022)
"Adult patients with septic shock and elevated (> 3 mmol/L) lactate between 2010 and 2014."	2.82	Randomized, Double-Blind, Placebo-Controlled Trial of Thiamine as a Metabolic Resuscitator in Septic Shock: A Pilot Study. ( Andersen, LW; Berg, KM; Chase, M; Cocchi, MN; Donnino, MW; Giberson, T; Moskowitz, A; Ngo, L; Smithline, H; Tidswell, M; Wolfe, R, 2016)
"Levosimendan-treated patients had higher stroke volume index (SVI), cardiac index (CI), LVEF, and left ventricular stroke work index (LVSWI), and lower extravascular lung water index (EVLWI) compared to dobutamine-treated patients (p<0."	2.82	Levosimendan Versus Dobutamine in Myocardial Injury Patients with Septic Shock: A Randomized Controlled Trial. ( Hu, MH; Ji, CL; Lai, ZZ; Meng, JB; Tian, S; Xu, XJ; Zhang, G, 2016)
"To explore the effect of early goal-directed therapy (EGDT) combined with Yiqi Fumai Lyophilized Powder (YFLP) on central venous-arterial carbon dioxide difference [P(cv-a)CO2] and central venous oxygen saturation (S(cv)O2) in patients with septic shock."	2.82	[Effects of Early Goal-directed Therapy Combined with Yiqi Fumai Lyophilized Powder on P(cv-a) CO2 and S(cv)O2 in Patients with Septic Shock]. ( Xie, RF, 2016)
"Septic shock has a 90-day mortality risk of up to 50 %."	2.82	Targeted tissue perfusion versus macrocirculation-guided standard care in patients with septic shock (TARTARE-2S): study protocol and statistical analysis plan for a randomized controlled trial. ( Hästbacka, J; Hjortrup, PB; Jakob, SM; Karlsson, S; Kuitunen, A; Lange, T; Merz, T; Perner, A; Pettilä, V; Takala, J; Wilkman, E, 2016)
"For this purpose, a total of 45 septic shock patients were randomly divided into control group A (24 patients on EGDT) and experimental group B (21 patients on SFI + EGDT)."	2.80	Effect of the Shenfu Injection Combined with Early Goal-Directed Therapy on Organ Functions and Outcomes of Septic Shock Patients. ( Han, GJ; Li, MQ; Mo, X; Pan, CG; Shi, ZX; Wang, XM; Xu, JY; Xu, YJ, 2015)
"100 patients diagnosed with septic shock from June 2012 to June 2014 in department of critical care medicine of sixteen hospitals were enrolled."	2.80	[Efficacies of fluid resuscitation as guided by lactate clearance rate and central venous oxygen saturation in patients with septic shock]. ( Cai, G; Lyu, X; Xu, Q; Yan, J; Yan, M, 2015)
"Besides conventional treatment for septic shock, patients in control group were given 200 mg/d hydrocortisone intravenous infusion lasting for 2 hours, while those of research group were given 8."	2.80	[The impacts of low-dose corticosteroids infusion given in different manners on refractory septic shock patients]. ( Chen, Z; He, H; He, Z; Yang, C, 2015)
"kg-1."	2.79	[The significance of lactic acid in early diagnosis and goal-directed therapy of septic shock patients]. ( Gao, F; Han, S; Hao, D; Li, Z; Qi, Z; Sun, J; Sun, T; Tian, H; Wang, T; Wang, X; Xia, Y; Zhang, X, 2014)
"Eighty children with septic shock treated with bundle treatment in Department of Critical Care Medicine were retrospectively analyzed."	2.78	[Clinical research of timing of application of antibiotics in septic shock of pediatric patients]. ( Cao, LJ; Geng, WJ; Guo, YM; Huo, XM; Kang, L; Li, JE; Li, P; Shi, HY; Shi, XN; Sun, H; Wang, XD; Xu, MX, 2013)
"Thirty consecutive patients with septic shock were prospectively included on ICU admission."	2.77	Defining metabolic acidosis in patients with septic shock using Stewart approach. ( Mallat, J; Michel, D; Salaun, P; Thevenin, D; Tronchon, L, 2012)
"In this randomized, perspective study, septic shock patients with severe pneumonia were divided into control group and experimental group, which included 10% lactate clearance rate group and 30% lactate clearance rate group, adopting random number method."	2.77	[The effect of early goal lactate clearance rate on the outcome of septic shock patients with severe pneumonia]. ( Han, SS; Hao, D; Li, Z; Lv, CJ; Shang, QM; Tian, HH; Wang, T; Wang, XZ, 2012)
"Goal-directed resuscitation for severe sepsis and septic shock has been reported to reduce mortality when applied in the emergency department."	2.75	Lactate clearance vs central venous oxygen saturation as goals of early sepsis therapy: a randomized clinical trial. ( Arnold, RC; Claremont, HA; Jones, AE; Kline, JA; Shapiro, NI; Trzeciak, S, 2010)
"Eighty-nine patients with refractory septic shock and MODS undergoing HVHF, fluid resuscitation were included in the trial, and they were randomly divided into fluid resuscitation group (group A, 41 cases) and HVHF and fluid resuscitation group (group B, 48 cases)."	2.74	[Study the effects of high-volume hemofiltration and fluid resuscitation on removing blood lactic acid and pro-inflammatory cytokines in patients with refractory septic shock]. ( Chu, YF; Ding, M; Jiang, JJ; Meng, M; Ren, HS; Wang, CT; Yu, JB; Zhang, JC, 2009)
"For the patients with septic shock with refractory hypotension, low-dose hydrocortisone can decrease the time course and dosage of vasopressors, improve tissue oxygen supply, thus can reverse septic shock more rapidly."	2.74	[The effect of low-dose hydrocortisone on requirement of norepinephrine and lactate clearance in patients with refractory septic shock]. ( Gan, Q; Hu, B; Li, JG; Li, L; Liang, H; Liu, C; Luo, Y; Yu, Z; Zhou, Q, 2009)
" A volume therapy with exclusively crystalloids or colloids with the chosen colloid hyperoncotic, hyperchloremic HES solution (10% hydroxyethyl starch: 10% Hemohes) or the crystalloid solution with high lactate content (Sterofundin) is neither acceptable nor practicable, even if only due to exceeding the maximum dosage as recommended by the manufacturer."	2.73	[The design of the VISEP trial. Critical appraisal]. ( Boldt, J; Engelmann, L; Mertzlufft, F; Sirtl, C; Stuttmann, R; Zander, R, 2007)
"We enrolled 30 patients with septic shock requiring invasive hemodynamic monitoring and norepinephrine infusion of 0."	2.73	Glibenclamide dose response in patients with septic shock: effects on norepinephrine requirements, cardiopulmonary performance, and global oxygen transport. ( Bachetoni, A; Broeking, K; Ertmer, C; Landoni, G; Lange, M; Morelli, A; Orecchioni, A; Pietropaoli, P; Rocco, M; Traber, DL; Van Aken, H; Westphal, M, 2007)
"Eight patients with fluid-resuscitated septic shock requiring norepinephrine (>0."	2.73	Norepinephrine in low to moderate doses may not increase luminal concentrations of L-lactate in the gut in patients with septic shock. ( Ibsen, M; Jørgensen, VL; Perner, A, 2007)
"Sepsis is a common disease process encountered by physicians."	2.72	Macrocirculatory and Microcirculatory Endpoints in Sepsis Resuscitation. ( Gray, S; Hendin, A; Hickey, M; Mok, G; Reardon, P; Yadav, K, 2021)
"In patients with severe sepsis or septic shock, 250 ml HS transiently (<120 min) increases CI and PCWP and induces an increase in sodium and chloride concentrations."	2.71	[Short term effects of hypertonic saline during severe sepsis and septic shock]. ( de La Coussaye, JE; Eledjam, JJ; Jaber, S; Lefrant, JY; Louart, G; Mahamat, A; Muller, L; Ripart, J, 2004)
"A convenience cohort of patients with severe sepsis or septic shock."	2.71	Early lactate clearance is associated with improved outcome in severe sepsis and septic shock. ( Jacobsen, G; Knoblich, BP; Muzzin, A; Nguyen, HB; Ressler, JA; Rivers, EP; Tomlanovich, MC, 2004)
"Both causes of septic shock are associated with an extremely high severity of illness (Acute Physiology and Chronic Health Evaluation II: candidemic septic shock, 32 +/- 10; bacteremic septic shock, 30 +/- 8; p =."	2.70	Candidemia as a cause of septic shock and multiple organ failure in nonimmunocompromised patients. ( Hadley, S; Lee, WW; Nasraway, SA; Ruthazer, R, 2002)
"Fifteen patients with septic shock associated with persisting hypotension despite conventional treatment including fluid loading, vasopressors, and inotropes."	2.70	Does methylene blue administration to septic shock patients affect vascular permeability and blood volume? ( Coltrinari, R; Conti, G; Donati, A; Loggi, S; Münch, C; Pelaia, P; Pietropaoli, P; Preiser, JC, 2002)
"Fourteen patients with severe septic shock requiring adrenergic therapy."	2.68	Methylene blue administration in septic shock: a clinical trial. ( Carlier, E; De Backer, D; Kahn, RJ; Leeman, M; Lejeune, P; Preiser, JC; Roman, A; Vincent, JL, 1995)
"Ten patients with hyperdynamic septic shock (ages ranging from 45."	2.67	Regional blood flow and oxygen transport in septic shock. ( Hansen, EJ; Kari, A; Mertsola, J; Ruokonen, E; Saxén, H; Takala, J, 1993)
"Septic shock is the main cause of morbidity and mortality in patients and second leading cause of mortality among subjects in noncoronary intensive care units."	2.66	Early lactate area scores and serial blood lactate levels as prognostic markers for patients with septic shock: a systematic review. ( Khodashahi, R; Sarjamee, S, 2020)
"The new definitions of sepsis and septic shock reflect the inadequate sensitivity, specify, and lack of prognostication of systemic inflammatory response syndrome criteria."	2.55	Sepsis and Septic Shock Strategies. ( Armstrong, BA; Betzold, RD; May, AK, 2017)
"Accordingly, sepsis is now defined as a life-threatening organ dysfunction due to a falsely regulated response of the body to an infection."	2.55	[Updated definition of sepsis : Implications for diagnostics and therapy principles]. ( Schlegel, N, 2017)
"The current practice in treatment of severe sepsis and septic shock is to ensure adequate oxygenation and perfusion in patients, along with prompt administration of antibiotics, within 6 hours from diagnosis, which is considered the "golden hour" for the patients."	2.53	The role of central venous oxygen saturation, blood lactate, and central venous-to-arterial carbon dioxide partial pressure difference as a goal and prognosis of sepsis treatment. ( Chattipakorn, N; Chentanakij, B; Sruamsiri, K; Wittayachamnankul, B, 2016)
"When sepsis is accompanied by conditions in which systemic oxygen delivery does not meet tissue oxygen demands, tissue hypoperfusion begins."	2.52	Oxygen extraction and perfusion markers in severe sepsis and septic shock: diagnostic, therapeutic and outcome implications. ( Disselkamp, M; Gill, J; Jaehne, AK; Rivers, EP; Yataco, AC, 2015)
"In the developed countries septic shock has a favorable outcome for the majority of previously healthy children but also in children with comorbidities if all available medical resources were used."	2.49	Early recognition of septic shock in children. ( Dohna-Schwake, C; Felderhoff-Müser, U, 2013)
"Sepsis affects the cardiovascular system through multiple mechanisms, and often these derangements result in tissue hypoperfusion."	2.45	Sepsis-induced tissue hypoperfusion. ( Jones, AE; Puskarich, MA, 2009)
"Septic shock is characterised by vasodilation, myocardial depression and impaired microcirculatory blood flow, resulting in redistribution of regional blood flow."	2.44	Gastrointestinal perfusion in septic shock. ( Pickkers, P; Sleigh, JW; Van der Hoeven, JG; van Haren, FM, 2007)
"This is also true for patients in septic shock after plasma volume expansion."	2.39	[Is infection and septic shock caused by a global oxygen deficiency? An overview in 2 parts. 1: Infection and correlation between DO2 and VO2]. ( Ensinger, H; Georgieff, M, 1996)
"Patients with sepsis or septic shock according to Sepsis-3 Consensus criteria."	1.91	Association between septic patient mortality and blood survivin concentrations. ( Ferrer-Moure, C; González-Rivero, AF; Jiménez, A; Lorente, L; Martín, MM; Ortiz-López, R; Pérez-Cejas, A, 2023)
"Sepsis is a potentially life-threatening systemic dysregulatory response to infection, and septic shock occurs when sepsis leads to systemic vasodilation and subsequent tissue hypoperfusion."	1.91	How Would You Resuscitate This Patient With Septic Shock? : Grand Rounds Discussion From Beth Israel Deaconess Medical Center. ( Bell, TD; Berg, K; Kanjee, Z; Reynolds, EE, 2023)
"In 2015, the Severe Sepsis and Early Septic Shock Management Bundle (SEP-1) tied hospital reimbursement to performance on a series of time sensitive indicators, including ordering blood cultures on patients with severe sepsis or septic shock."	1.91	Overcultured? Blood cultures on discharged ED patients were ordered more frequently after the SEP-1 bundle initiation. ( Lamonge, R; Rech, MA; Semenchuck, N; Sterk, E; Wassermann, T, 2023)
"0 g/dL, serum lactate concentration greater than or equal to 2 mmol/L, MAP less than 60 mmHg, or vasopressor dosage between 0."	1.91	Identification of indications for albumin administration in septic patients with liver cirrhosis. ( Chen, H; Hu, W; Huang, W; Huang, Y; Ma, C; Peng, Q; Sun, Q; Wang, H; Wang, J; Xie, J; Yang, M; Zhang, C, 2023)
"Sepsis and septic shock are disorders of tissue perfusion and microcirculation associated with increased mortality."	1.91	The role of proadrenomedullin, interleukin 6 and CD64 in the diagnosis and prognosis of septic shock. ( Turan, YB, 2023)
"Adult patients who met criteria for septic shock based on the U."	1.72	Association of Catecholamine Dose, Lactate, and Shock Duration at Vasopressin Initiation With Mortality in Patients With Septic Shock. ( Bauer, SR; Duggal, A; Lam, SW; Reddy, AJ; Sacha, GL; Wang, L, 2022)
"Adult septic shock patients visiting the ED with 28-day survival after admission were included."	1.72	Prognostic factors for late death in septic shock survivors: a multi-center, prospective, registry-based observational study. ( Choi, SH; Chung, SP; Jo, YH; Kim, SM; Kim, WY; Lim, TH; Park, YS; Ryoo, SM; Shin, TG; Suh, GJ, 2022)
"Patients with septic shock (n = 415) were classified into early and late groups according to whether the vasopressor was initiated within 1 hour of the first resuscitative fluid load."	1.72	Vasopressor Initiation Within 1 Hour of Fluid Loading Is Associated With Increased Mortality in Septic Shock Patients: Analysis of National Registry Data. ( Cho, WH; Jang, JH; Kim, TH; Lee, HB; Lee, YS; Lim, CM; Oh, DK; Park, MH; Yeo, HJ, 2022)
"Baseline respiration at the time of septic shock diagnosis was correlated with lactate (Spearman -0."	1.72	Association Between Hyperlactatemia, Perfusional Parameters, and Lymphocyte Mitochondrial Dysfunction in Septic Shock Patients. ( Friedman, G; Júnior, JA; Kopczynski, A; Montes, THM; Nedel, WL; Portela, LV; Rodolphi, MS; Strogulski, NR, 2022)
"The NLRP3 levels in the septic shock group was significantly higher (431."	1.72	Serum NLRP3: A biomarker for identifying high-risk septic patients. ( Huang, W; Liu, D; Wang, X; Xie, F; Zhang, H, 2022)
"Sepsis is a common cause of emergency department (ED) presentation and hospital admission, accounting for a disproportionate number of deaths each year relative to its incidence."	1.72	Quality initiative to improve emergency department sepsis bundle compliance through utilisation of an electronic health record tool. ( Caldwell, JR; Dahn, C; Jamin, C; Mandola, S; Tang, N; Warstadt, NM, 2022)
"Sepsis is a life-threating organ dysfunction caused by a dysregulated host response to infection."	1.72	A 2-year retrospective analysis of the prognostic value of MqSOFA compared to lactate, NEWS and qSOFA in patients with sepsis. ( Alfano, F; Caio, G; Catanese, EM; Contini, C; De Giorgi, A; De Giorgio, R; Gambuti, E; Guarino, M; Perna, B; Strada, A; Volpato, S, 2022)
"Sepsis is a host response with life-threatening organ dysfunction caused by an infection."	1.72	Risk stratification and prognostic value of serum neutrophil gelatinase-associated lipocalin (sNGAL) in sepsis patients. ( Fan, J; He, ZM; Sun, Y; Wu, Y; Yu, C; Zhang, W; Zhou, Y, 2022)
"Patients with septic shock admitted to the department of critical care medicine of Jiangxi Provincial People's Hospital from January 1, 2018 to December 31, 2020 were enrolled, and they were divided into control group and observation group according to random number table method."	1.72	[Efficacy analysis of inferior vena cava variability combined with difference of central venous-to-arterial partial pressure of carbon dioxide on guiding fluid resuscitation in patients with septic shock]. ( He, H; He, Z; Wang, R; Yang, C; Yang, X, 2022)
"Children having septic shock aged from 3 to 60 months were studied within the first 24 hours of admission."	1.72	Evaluation of Venous-to-Arterial Carbon Dioxide Tension Difference as a Complementary Parameter During Pediatric Septic Shock Resuscitation: A Prospective Observational Study. ( El-Nawawy, AA; Hassaan, SM; Hassouna, HM, 2022)
"A total of 76 patients with septic shock who received blood purification therapies were enrolled."	1.72	Effect of oXiris-CVVH on the Clinical Outcomes of Patients with Septic Shock: An Inverse Probability of Treatment-Weighted Analysis. ( Lin, J; Xiao, W; Xie, J, 2022)
"Sepsis is a heterogeneous syndrome that results in life-threatening organ dysfunction."	1.72	Septic Shock: Phenotypes and Outcomes. ( Boucekine, M; Cereuil, A; Culver, A; Lefebvre, L; Leone, M; Papazian, L; Ronflé, R, 2022)
"The main goal of septic shock therapy is to keep hemodynamic parameters in the normal range for adequate tissue perfusion."	1.72	Is vasoactive-inotropic score associated with early lactate clearance a predictive outcome of children with septic shock? ( Çeleğen, K; Çeleğen, M, 2022)
"Seventy-five patients with septic shock hospitalized in the emergency intensive care unit (EICU) of Hebei General Hospital from March 2020 to September 2021 were included, and the patients' baseline characteristics and laboratory findings were collected."	1.72	The value of NSE to predict ICU mortality in patients with septic shock: A prospective observational study. ( Cao, SM; Han, H; Li, JG; Li, LL; Lv, J; Xu, X; Zhang, LR; Zhang, LT, 2022)
"In a rabbit model of endotoxic shock, 2MT had a positive effect on MAP and jejunal mucosal tissue blood flow."	1.72	EFFECTS OF 2-METHYL-2-THIAZOLINE ON CIRCULATORY DYNAMICS AND INTESTINAL VASCULAR SYSTEM IN RABBITS WITH ENDOTOXIC SHOCK. ( Ikegawa, H; Kobayakawa, K; Kobayakawa, R; Kuwagata, Y; Muroya, T; Nakamura, F; Onoe, A, 2022)
"Sepsis and septic shock represent a significant worldwide mortality burden."	1.72	Premorbid beta blockade in sepsis is associated with a lower risk of a lactate concentration above the lactate threshold, a retrospective cohort study. ( Cave, G; Chalmers, D; Greenberg, M; O'Beirn, S; Schneider, L, 2022)
"Sepsis is a life-threatening condition and remains a major cause of mortality."	1.72	Clinical usefulness of biomarkers for diagnosis and prediction of prognosis in sepsis and septic shock. ( Jang, HJ; Jang, JH; Jo, KM; Kim, SH; Lee, HK; Lee, JH; No, TH; Park, JH, 2022)
"In patients with septic shock, visually-assessed RV dysfunction was associated with in-hospital mortality, lethal arrhythmia, and circulatory insufficiency independent of LV dysfunction."	1.62	Clinical impact of visually assessed right ventricular dysfunction in patients with septic shock. ( Furusawa, K; Goto, Y; Higashi, M; Hiraiwa, H; Jingushi, N; Kasugai, D; Kondo, T; Matsuda, N; Matsui, S; Morimoto, R; Murohara, T; Nishida, K; Okumura, T; Ozaki, M, 2021)
"Septic shock was present at admission in 56."	1.62	Lactate Measurements and Their Association With Mortality in Pediatric Severe Sepsis in India: Evidence That 6-Hour Level Performs Best. ( Alam, A; Gupta, S, 2021)
"Patients with septic shock were identified from the Medical Information Mart for Intensive Care (MIMIC)-III database."	1.62	Association between normalized lactate load and mortality in patients with septic shock: an analysis of the MIMIC-III database. ( Chen, H; Gong, SR; Yu, RG, 2021)
"We enrolled 66 patients with sepsis or septic shock and compared 14 blood-based biomarkers in the first 24 h after ICU admission."	1.62	Mortality prediction using a novel combination of biomarkers in the first day of sepsis in intensive care units. ( Bai, C; Chen, W; Deng, D; Li, B; Liu, J; Shan, A; Shi, F; Wang, J; Xie, M; Yao, C; Zhang, Y, 2021)
"Respiratory failure was the most frequently observed complication (106 [67."	1.62	Identification of risk factors for in-hospital death of COVID - 19 pneumonia -- lessions from the early outbreak. ( Wang, Z, 2021)
"Endpoints were bacteremia, septic shock, and in-hospital mortality, related to the same ED visit."	1.62	Lack of admission biomarkers' clinical utility in outcomes prediction in patients suspected with infection in the emergency department. ( De Ruffi, S; Gennai, S; Giordano Orsini, G; Gornet, M; Kanagaratnam, L; Leroux, P; Losset, X; Ramont, L, 2021)
"All patients with a diagnosis of liver cirrhosis and septic shock were enrolled."	1.62	Effectiveness of sepsis bundle application and outcomes predictors to cirrhotic patients with septic shock. ( Hsu, YC; Yang, YY, 2021)
"The study cohort comprised 90 pediatric septic shock patients admitted from February 2012 to May 2015."	1.62	Association between the lactate/albumin ratio and mortality in pediatric septic shock patients with underlying chronic disease: retrospective pilot study. ( Choi, SJ; Ha, EJ; Jhang, WK; Park, SJ, 2021)
"2,584 septic shock patients were enrolled."	1.56	Presentation and outcomes of end stage liver disease patients presenting with septic shock to the emergency department. ( Heffner, AC; Okonkwo, E; Rozario, N, 2020)
"Early intervention for septic shock is crucial to reduce mortality and improve outcome."	1.56	Efficacy of 4-hour rescue therapeutic plasma exchange in severe septic shock patients. ( Ahmed, RM; Faris, F; Marzouk, K; Soliman, AR; Yousry, A, 2020)
"Subgroup analysis with septic shock, bacteraemia and high-grade infection did not affect mortality rates."	1.56	Timing of antibiotics in septic patients: a prospective cohort study. ( Choi, HK; Choi, WS; Jeon, JH; Moon, S; Park, DW; Seok, H; Song, J, 2020)
"A cohort of patients with septic shock was assembled."	1.56	Fluid overload in patients with septic shock and lactate clearance as a therapeutic goal: a retrospective cohort study. ( Espinosa-Almanza, CJ; Riaño-Forero, I; Sanabria-Rodríguez, O; Toro-Trujillo, E, 2020)
"The new septic shock definition may be useful for identifying high-risk patients requiring intensive care."	1.56	A mortality analysis of septic shock, vasoplegic shock and cryptic shock classified by the third international consensus definitions (Sepsis-3). ( Jung, SK; Kang, HD; Kim, WY; Kim, YJ; Lee, YJ; Oh, SH; Sohn, CH; Yang, WS, 2020)
"The application of RAI in children with septic shock has not been reported."	1.56	Assessment of early renal angina index for prediction of subsequent severe acute kidney injury during septic shock in children. ( Huang, L; Huang, S; Li, W; Li, X; Li, Y; Liu, X; Quan, W; Shi, T; Zhang, L, 2020)
"In patients with cancer having septic shock, LA >2."	1.56	Evaluating the Predictive Value of Lactate in Patients With Cancer Having Septic Shock. ( Hawari, FI; Nazer, LH; Rimawi, D, 2020)
"According to the new definition of septic shock, vasopressor therapy and hyperlactatemia are essential for diagnosis."	1.51	Risk factors for mortality in patients with low lactate level and septic shock. ( Choi, JY; Jeong, SJ; Jeong, WY; Jung, IY; Kim, EJ; Kim, JM; Kim, MH; Kim, YC; Ku, NS; Oh, DH; Song, JE; Song, YG, 2019)
"The RR of hospital mortality of septic shock was 10."	1.51	Application of the new Sepsis-3 definition in a cohort of patients with severe sepsis and septic shock admitted to Intensive Care Unit from the Emergency Department. ( García-Gigorro, R; Molina-Collado, Z; Montejo González, JC; Sáez-de la Fuente, I; Sanchez-Izquierdo, JÁ, 2019)
"Maternal sepsis is a significant cause of maternal morbidity and mortality and is a preventable cause of maternal death."	1.51	SMFM Consult Series #47: Sepsis during pregnancy and the puerperium. ( Louis, JM; Pacheco, LD; Plante, LA, 2019)
"A cohort of adult septic shock patients admitted to the ICU with an initial lactate level >2 mmol/L and receiving vasopressor was retrospectively analysed."	1.51	Optimal cut-off for hourly lactate reduction in ICU-treated patients with septic shock. ( Grip, J; Norberg, Å; Promsin, P; Rooyackers, O; Wernerman, J, 2019)
"Sepsis is one of the leading causes of death globally, with significant associated costs."	1.51	Does Gender Matter in Septic Patient Outcomes? ( Bush, R; Connelly, CD; Ecoff, L; Failla, KR; Macauley, K, 2019)
"Data from a septic shock registry from October 2015 to February 2017 were reviewed."	1.51	Lactate normalization within 6 hours of bundle therapy and 24 hours of delayed achievement were associated with 28-day mortality in septic shock patients. ( Ahn, R; Beom, JH; Choi, SH; Chung, SP; Jo, YH; Kim, WY; Ko, BS; Lee, HJ; Ryoo, SM; Shin, TG; Suh, GJ; Yoon, YH, 2019)
"Patients younger than 18 years treated for septic shock were included if they had a serum lactate obtained in the PED."	1.51	Association Between Initial Emergency Department Lactate and Use of Vasoactive Medication in Children With Septic Shock. ( Lane, RD; Larsen, GY; Miescier, MJ; Sheng, X, 2019)
"Clear definitions for septic shock assist clinicians regarding recognition, treatment and standardized reporting of characteristics and outcome of this entity."	1.48	The influence of a change in septic shock definitions on intensive care epidemiology and outcome: comparison of sepsis-2 and sepsis-3 definitions. ( Driessen, RGH; Mol, MF; Schnabel, RM; van de Poll, MCG; van Mook, WNKA, 2018)
"Sepsis is a potentially fatal condition with high treatment costs, and is especially common among the elderly population."	1.48	Effect of platelet-lymphocyte ratio and lactate levels obtained on mortality with sepsis and septic shock. ( Biyikli, E; Kavalci, C; Kayipmaz, AE, 2018)
"Patients with culture-negative septic shock and culture-positive septic shock derived from a trinational (n = 8,670) database of patients with septic shock."	1.48	Culture-Negative Septic Shock Compared With Culture-Positive Septic Shock: A Retrospective Cohort Study. ( Bilgili, B; Kethireddy, S; Kirchner, HL; Kumar, A; Layon, AJ; Light, RB; Maki, D; Mirzanejad, Y; Ofoma, UR; Parrillo, JE; Sees, A, 2018)
"From 5,072 patients with severe sepsis or septic shock, 1,412 (27."	1.48	Delay Within the 3-Hour Surviving Sepsis Campaign Guideline on Mortality for Patients With Severe Sepsis and Septic Shock. ( Delaney, CW; Hoff, A; Kumar, V; Pruinelli, L; Simon, G; Steinbach, M; Westra, BL; Yadav, P, 2018)
"We included septic shock patients who met the Sepsis-3 definition, which involves lactate levels greater than or equal to 2 mmol/L and vasopressor use."	1.48	Lactate Level Versus Lactate Clearance for Predicting Mortality in Patients With Septic Shock Defined by Sepsis-3. ( Hong, SB; Huh, JW; Kim, WY; Koh, Y; Lee, J; Lee, JH; Lee, YS; Lim, CM; Lim, KS; Ryoo, SM, 2018)
"It seems reasonable for septic shock to be defined by the lactate levels after volume resuscitation."	1.48	Prognosis of patients excluded by the definition of septic shock based on their lactate levels after initial fluid resuscitation: a prospective multi-center observational study. ( Beom, JH; Choi, HS; Choi, SH; Chung, SP; Han, KS; Jo, YH; Kang, GH; Kim, K; Kim, WY; Ko, BS; Kwon, WY; Lim, TH; Ryoo, SM; Shin, TG; Suh, GJ, 2018)
"Systemic inflammatory response syndrome was also recorded."	1.48	Predictive Validity of Sepsis-3 Definitions and Sepsis Outcomes in Critically Ill Patients: A Cohort Study in 49 ICUs in Argentina. ( Díaz, A; Dubin, A; Estenssoro, E; Kanoore Edul, VS; Klein, F; Lattanzio, B; Loudet, CI; Osatnik, J; Pálizas, F; Piezny, D; Pozo, MO; Ríos, FG; Rubatto Birri, PN; Santamaría, A; Tuhay, G; Vázquez, DN; Zakalik, G, 2018)
"In cases of Polytrauma induced sepsis or septic shock, the level started to increase within first 72 hours after traumatic injury, pick concentration was achieved within first 25 days high from the beginning and dynamically increases within first 25 days, the tendency of gradual decrease was seen after 30 days."	1.48	THE ROLE OF PROCALCITONIN AND BLOOD LACTIC ACID VALUES IN PROGNOSIS OF SEPSIS AND SEPTIC SHOCK IN POLYTRAUMA PATIENTS. ( Kanashvili, B; Ratiani, L; Saganelidze, K, 2018)
"Changes in vascular reactivity during endotoxic shock are organ-specific."	1.48	Organ-specific changes in vascular reactivity and roles of inducible nitric oxide synthase and endothelin-1 in a rabbit endotoxic shock model. ( Chen, W; Li, T; Liu, LM; Zhang, ZS, 2018)
"Fifty-sixpatients with septic shock were prospectively investigated."	1.48	[Correlation of transcutaneous oxygen pressure and blood lactate in patients with septic shock]. ( Dai, HW; Gong, SJ; Wang, MJ; Xu, L; Yan, J; Ye, C, 2018)
"Children with septic shock admitted to neonatal intensive care unit (NICU) of the First Affiliated Hospital of Gannan Medical University were enrolled."	1.48	[Effects of 37 centigrade volume resuscitation on coagulation function and blood lactic acid in neonates with septic shock]. ( Liao, H; Luo, K; Shen, Z; Tu, Q; Wang, H; Zhong, M; Zhong, X, 2018)
"in patients with sepsis and septic shock, achievement of lactate clearance and ScvO2 targets associates with similar early mortality risk compared to achievement of lactate clearance target only."	1.48	Comparison of Survival Prediction with Single versus Combination Use of Microcirculation End Point Resuscitation in Sepsis and Septic Shock. ( Sinto, R; Suwarto, S; Widodo, D, 2018)
"Hyperoxia was associated with a higher sublingual microcirculatory flow over time, with higher cerebral perfusion and brain tissue oxygen pressure and with a lower cerebral lactate-to-pyruvate ratio than in control animals."	1.46	Should Hyperoxia Be Avoided During Sepsis? An Experimental Study in Ovine Peritonitis. ( Donadello, K; He, X; Su, F; Taccone, FS; Vincent, JL; Xie, K, 2017)
"The ability of MOx to detect even mild septic shock has meaningful implications for emergency care, where decisions about triage and therapy must be made quickly and accurately."	1.46	Muscle oxygenation as an indicator of shock severity in patients with suspected severe sepsis or septic shock. ( Arakaki, LSL; Asplund, KM; Bulger, EM; Carlbom, DJ; Ciesielski, WA; Fisk, DM; Schenkman, KA; Shaver, JM; Sheehan, KL, 2017)
"Hyperlactatemia was defined as a blood lactate concentration ≥5mmol/L and high-grade hyperlactatemia a lactate level ≥10mmol/L."	1.46	Hyperlactatemia in ICU patients: Incidence, causes and associated mortality. ( Ayestarán, I; Ferreruela, M; Llompart-Pou, JA; Raurich, JM, 2017)
"The key to the treatment of septic shock is to provide adequate oxygen supply and improve tissue perfusion."	1.46	[Changes in blood oxygen metabolism indices and their clinical significance in children with septic shock]. ( Xu, D; Xu, LY, 2017)
"It has higher predictive efficacy in septic shock, especially for 28-day prognosis."	1.46	Clinical study of a new Modified Early Warning System scoring system for rapidly evaluating shock in adults. ( Cao, Y; Qin, Q; Xia, Y, 2017)
"We performed a post hoc analysis of 513 septic shock patients with admission blood lactate measurements in the prospective, observational, multicenter FINNAKI study."	1.46	Evolution of Blood Lactate and 90-Day Mortality in Septic Shock. A Post Hoc Analysis of the FINNAKI Study. ( Jakob, SM; Karlsson, S; Perner, A; Pettilä, V; Poukkanen, M; Takala, J; Varis, E; Wilkman, E, 2017)
"Sensitivity and specificity are different between these parameters."	1.46	Absolute lactate value vs relative reduction as a predictor of mortality in severe sepsis and septic shock. ( Andersen, LW; Cocchi, MN; Donnino, MW; Lokhandwala, S; Nair, S; Patel, P, 2017)
"Septic shock was associated with reduced renal perfusion and decreased cortical and medullary blood flow, followed by signs of anaerobic metabolism in the cortex when flow reductions became critical."	1.46	Changes in kidney perfusion and renal cortex metabolism in septic shock: an experimental study. ( Creteur, J; De Backer, D; Herpain, A; Hosokawa, K; Post, EH; Su, F; Taccone, FS; Vincent, JL, 2017)
"The definitions of sepsis and septic shock have recently been revised in adults, but contemporary data are needed to inform similar approaches in children."	1.46	Prediction of pediatric sepsis mortality within 1 h of intensive care admission. ( Alexander, J; Beca, J; Erickson, S; Festa, M; MacLaren, G; Millar, J; Pilcher, D; Schibler, A; Schlapbach, LJ; Slater, A; Straney, L, 2017)
"Septic shock was significantly associated with age ≥60 years [odds ratio (OR): 2."	1.46	Predictors of septic shock in initially stable patients with pyogenic liver abscess. ( Ahn, S; Cho, H; Kim, WY; Kim, YJ; Lee, ES; Lee, JH; Lee, YS; Lim, KS; Seo, DW; Sohn, CH, 2017)
"We enrolled 411 adult patients with severe sepsis and lactate ≥4."	1.43	Risk factors for mortality despite early protocolized resuscitation for severe sepsis and septic shock in the emergency department. ( Agarwal, A; Drumheller, BC; Gaieski, DF; Goyal, M; Mikkelsen, ME; Sante, SC; Weber, AL, 2016)
"We enrolled adult patients in septic shock and with an elevated lactate (>3 mmol/L)."	1.43	Cytochrome C in Patients with Septic Shock. ( Andersen, LW; Balkema, JL; Berg, KM; Chase, M; Cocchi, MN; Donnino, MW; Gazmuri, RJ; Holmberg, MJ; Liu, X; Montissol, S; Sulmonte, C, 2016)
"Of 770 patients with severe sepsis or septic shock, 208 (27%) with hepatic dysfunction were included in the analysis."	1.43	Lactate clearance and mortality in septic patients with hepatic dysfunction. ( Chung, CR; Ha, TS; Hwang, SY; Jeon, K; Jo, IJ; Shin, TG; Suh, GY, 2016)
"Persistent hyperlactatemia during septic shock is multifactorial."	1.43	Effects of dexmedetomidine and esmolol on systemic hemodynamics and exogenous lactate clearance in early experimental septic shock. ( Achurra, P; Alegría, L; Bakker, J; Bruhn, A; Castro, R; Gomez, J; Hernández, G; Jarufe, N; Kattan, E; Luengo, C; Ospina-Tascón, G; Rebolledo, R; Soto, D; Tapia, P, 2016)
"To investigate the prognostic significance of venous-to-arterial carbon dioxide difference to arteriovenous oxygen content difference ratio (Pv-aCO2/Ca-vO2 ratio) combined with lactate in patients with septic shock during the early phases of resuscitation."	1.43	[Venous-to-arterial carbon dioxide difference to arteriovenous oxygen content difference ratio combined with lactate to predict prognosis of patients with septic shock]. ( Dai, HW; Gong, SJ; Li, L; Song, J; Wang, MJ; Xu, QH; Yan, J; Yu, YH; Zhou, JD, 2016)
"Although overall paediatric septic shock mortality is decreasing, refractory septic shock (RSS) is still associated with high mortality."	1.43	Refractory septic shock in children: a European Society of Paediatric and Neonatal Intensive Care definition. ( Benissa, MR; De Luca, D; Jansen, NJG; Javouhey, E; Kneyber, M; Maclaren, G; Morin, L; Nadel, S; Peters, MJ; Ray, S; Remy, S; Schlapbach, LJ; Tissieres, P; Wilson, C, 2016)
"A total of 115 patients with septic shock were included in the study."	1.42	Combination of Acute Physiology and Chronic Health Evaluation II score, early lactate area, and N-terminal prohormone of brain natriuretic peptide levels as a predictor of mortality in geriatric patients with septic shock. ( Chen, XM; Ding, SF; Li, C; Li, Y; Li, Z; Liu, H; Wang, H; Wu, DW; Yin, M; Zhai, Q, 2015)
"Endothelial damage developing in severe sepsis or septic shock results in multiorgan dysfunction."	1.42	Clinical significance of circulating endothelial cells in patients with severe sepsis or septic shock. ( Hong, SB; Huh, JW; Koh, Y; Lim, CM; Moon, JY; Yoo, JW, 2015)
"A total of 50 patients with sepsis, severe sepsis or septic shock were included."	1.42	Prospective evaluation of regional oxygen saturation to estimate central venous saturation in sepsis. ( Hecker, A; Koch, C; Lichtenstern, C; Monz, T; Röhrig, R; Schneck, E; Uhle, F; Weigand, MA, 2015)
"Observational study."	1.42	Central venous-to-arterial carbon dioxide difference combined with arterial-to-venous oxygen content difference is associated with lactate evolution in the hemodynamic resuscitation process in early septic shock. ( Artigas, A; Baigorri, F; Espinal, C; Gruartmoner, G; Mesquida, J; Saludes, P; Torrents, E, 2015)
"Sepsis, including severe sepsis and septic shock, is a major cause of morbidity and mortality."	1.42	The C-Reactive Protein/Albumin Ratio as an Independent Predictor of Mortality in Patients with Severe Sepsis or Septic Shock Treated with Early Goal-Directed Therapy. ( Ahn, JY; Ann, HW; Choi, H; Choi, JY; Han, SH; Jeon, YD; Jeong, SJ; Kim, JH; Kim, JK; Kim, JM; Kim, MH; Kim, SB; Kim, YS; Ku, NS; Song, JE; Song, YG, 2015)
"Patients with severe sepsis/septic shock who were screened or contacted by a medical emergency team between January 2012 and August 2012 were enrolled at a university-affiliated hospital with ~2,700 beds, including 28 medical ICU beds."	1.42	A combination of early warning score and lactate to predict intensive care unit transfer of inpatients with severe sepsis/septic shock. ( Choi, SH; Hong, SB; Huh, JW; Jung, YK; Kang, BJ; Koh, Y; Lee, JR; Lim, CM; Park, TS; Son, JS; Yoo, JW, 2015)
"Patients with severe sepsis and septic shock are at high risk for development of pulmonary complications, including acute respiratory distress syndrome (ARDS)."	1.42	Sepsis-associated pulmonary complications in emergency department patients monitored with serial lactate: An observational cohort study. ( Dettmer, MR; Fuller, BM; Mohr, NM, 2015)
"Two hundred sixty patients with severe sepsis or septic shock were included."	1.42	Long-Term β-Blocker Therapy Decreases Blood Lactate Concentration in Severely Septic Patients. ( Contenti, J; Corraze, H; Lemoël, F; Levraut, J; Occelli, C, 2015)
"Septic shock is conceptualised as cardiovascular dysfunction, tissue perfusion and cellular abnormalities caused by infection."	1.42	Judging quality of current septic shock definitions and criteria. ( Annane, D; Bellomo, R; Bertolini, G; Brunkhorst, FM; Deutschman, CS; Shankar-Hari, M; Singer, M, 2015)
"Complete clinical data of patients with septic shock admitted to emergency intensive care unit (EICU) of Sichuan Provincial People's Hospital from May 1994 to December 2014 were recorded and analyzed."	1.42	[Improvement effect of early goal-directed therapy on the prognosis in patients with septic shock]. ( Li, C; Yun, D, 2015)
"Eighty patients with septic shock were consecutively recruited."	1.40	Central venous-to-arterial carbon dioxide partial pressure difference in early resuscitation from septic shock: a prospective observational study. ( Gasan, G; Lemyze, M; Mallat, J; Pepy, F; Thevenin, D; Tronchon, L; Vallet, B; Vangrunderbeeck, N, 2014)
"Severe sepsis and septic shock are associated with high mortality."	1.40	Therapeutic goal achievements during severe sepsis and septic shock resuscitation and their association with patients' outcomes. ( Permpikul, C; Sringam, P; Tongyoo, S, 2014)
"During septic shock management, the evaluation of microvascular perfusion by skin analysis is of interest."	1.40	Capillary refill time exploration during septic shock. ( Ait-Oufella, H; Alves, M; Baudel, JL; Bertinchamp, R; Bige, N; Boelle, PY; Galbois, A; Guidet, B; Maury, E; Pichereau, C, 2014)
""Cryptic shock" was defined as severe sepsis with a lactate level of 4 mmol/L or greater and normotension, "COS" was defined as initial CS that progressed to septic shock within 72 h, and "OS" was defined as septic shock on ED arrival."	1.40	Association between hemodynamic presentation and outcome in sepsis patients. ( Cha, WC; Hwang, SY; Jeon, K; Jeong, YK; Jo, IJ; Lee, TR; Shin, TG; Sim, MS; Song, KJ; Suh, GY, 2014)
"In our hypodynamic model of endotoxic shock, infusion of hypertonic sodium lactate improves hemodynamic and microvascular reactivity with a negative fluid balance and a better oxygenation."	1.40	Hypertonic sodium lactate improves fluid balance and hemodynamics in porcine endotoxic shock. ( Duburcq, T; Favory, R; Gmyr, V; Hubert, T; Jourdain, M; Maboudou, P; Mangalaboyi, J; Mathieu, D; Pattou, F; Quintane, L, 2014)
"001), and received larger dosage of vasoactive drugs [DA (μg × kg⁻¹ × min⁻¹): 14."	1.40	[Prognostic value of decreased vasopressin modulation in the late-phase of septic shock patients]. ( Li, D; Sun, J; Wang, C; Yang, X; Zhou, Q, 2014)
"Septic shock is a major healthcare problem effecting people worldwide with high mortality rate."	1.40	Mortality rate among patients with septic shock after implementation of 6-hour sepsis protocol in the emergency department of Thammasat University Hospital. ( Apibunyopas, Y, 2014)
"In this prospective study, 48 septic shock children seen in Shanghai Children's Hospital, Shanghai Jiao Tong University were enrolled from Jun 2012 to May 2014."	1.40	[Central venous-to-arterial carbon dioxide difference in critically ill pediatric patients with septic shock]. ( Chen, R; Cui, Y; Miao, H; Rong, Q; Xu, L; Zhang, Y, 2014)
"Septic shock is a serious condition leading to high mortality and morbidity."	1.39	Dynamics of central venous oxygen saturation and serum lactate during septic shock resuscitation. ( Noppakaorattanamanee, K; Permpikul, C; Poompichet, A; Ratanarat, R; Tongyoo, S, 2013)
"We enrolled 105 patients with septic shock hospitalized in the mixed intensive care unit of a tertiary hospital."	1.39	Elevated adipose tissue lactate to pyruvate (L/P) ratio predicts poor outcome in critically ill patients with septic shock: a microdialysis study. ( Armaganidis, A; Dimopoulou, I; Ilias, I; Kopterides, P; Nikitas, N; Theodorakopoulou, M; Vassiliadi, DA, 2013)
"85 patients with a new septic shock episode were included."	1.39	Persistently high venous-to-arterial carbon dioxide differences during early resuscitation are associated with poor outcomes in septic shock. ( Arango-Dávila, C; Bautista-Rincón, DF; Bermúdez, W; García, AF; Granados, M; Gutiérrez, A; Hernández, G; Ospina-Tascón, GA; Tafur, JD; Umaña, M, 2013)
"Perfusion assessment during septic shock resuscitation is difficult and usually complex determinations."	1.38	Evolution of peripheral vs metabolic perfusion parameters during septic shock resuscitation. A clinical-physiologic study. ( Bravo, S; Bruhn, A; Castro, R; Hernandez, G; Ince, C; Kattan, E; Neira, R; Pedreros, C; Romero, C; Rovegno, M; Veas, E, 2012)
"Seventy-two septic shock patients admitted to the intensive care unit (ICU) underwent critical care including PMMA-CHDF."	1.38	Treatment of septic shock with continuous HDF using 2 PMMA hemofilters for enhanced intensity. ( Abe, R; Hirasawa, H; Hirayama, Y; Matsumura, Y; Nakada, TA; Nakamura, M; Oda, S; Oshima, T; Sadahiro, T; Shinozaki, K; Tateishi, Y; Watanabe, E, 2012)
"Septic shock was induced in rats by peritonitis."	1.38	Comparison of equipressor doses of norepinephrine, epinephrine, and phenylephrine on septic myocardial dysfunction. ( Ducrocq, N; Furmaniuk, A; Hekalo, Z; Kimmoun, A; Levy, B; Marie, PY; Maskali, F; Poussier, S, 2012)
"Patients with a final diagnosis of septic shock requiring vasopressors were divided, based on initial lactate, to nonlactate expressors (0-2."	1.38	Prevalence and characteristics of nonlactate and lactate expressors in septic shock. ( Cocchi, MN; Donnino, MW; Dugas, AF; Gautam, S; Mackenhauer, J; Salciccioli, JD, 2012)
"Only 65% of patients with septic shock had hyperlactataemia at the onset of shock and 76% of these also had a high lactate/pyruvate ratio."	1.38	Lactate/pyruvate ratio as a marker of tissue hypoxia in circulatory and septic shock. ( Bruzzi de Carvahlo, F; Cotton, F; De Backer, D; Orellano-Jimenez, C; Rimachi, R; Vincent, JL, 2012)
"Patients with septic shock state prior to initial presentation has a lower 30 day survival compared to any other septic conditions."	1.38	The use of laboratory and physiological parameters in predicting mortality in sepsis induced hypotension and septic shock patients attending the emergency department. ( Azlan, K; Hisamuddin, NA, 2012)
"Is it really septic shock? Our aim was to determine differences in outcome between patients diagnosed as having septic shock but exhibiting normal vs elevated lactate levels during evolution."	1.37	Persistent sepsis-induced hypotension without hyperlactatemia: is it really septic shock? ( Angulo, D; Aranguiz, I; Bruhn, A; Bujes, A; Castro, R; de la Hoz, C; Hernandez, G; Larrondo, J; Romero, C, 2011)
"In the ICU, patients with septic shock were resuscitated with a combination of crystalloids, colloids and blood products."	1.37	Initial fluid resuscitation of patients with septic shock in the intensive care unit. ( Carlsen, S; Perner, A, 2011)
"Under conditions of septic shock, an increase in lactate levels was found to be a sensitive marker of tissue metabolism disorder."	1.37	Microdialysis detection of lactate in subcutaneous tissue as a reliable indicator of tissue metabolic disorders in an animal sepsis model. ( Hanyu, N; Hosoyama, A; Kawasaki, N; Kobayashi, K; Komatsu, H; Ohashi, H; Ohashi, M; Taira, Y; Wada, T, 2011)
"Of 307 patients with septic shock, 118 (38%) patients with hepatic dysfunction were eligible for this study."	1.37	Initial lactate level and mortality in septic shock patients with hepatic dysfunction. ( Chung, MP; Jeon, K; Kang, YR; Kim, H; Koh, WJ; Kwon, OJ; Suh, GY; Um, SW, 2011)
"Nitroglycerin was infused at a rate of 0."	1.37	Failure of nitroglycerin (glyceryl trinitrate) to improve villi hypoperfusion in endotoxaemic shock in sheep. ( Canales, HS; Canullén, C; Dubin, A; Edul, VS; Estenssoro, E; Ferrara, G; Ince, C; Martins, E; Murias, G; Pozo, MO, 2011)
"Early recognition and treatment in severe sepsis improve outcomes."	1.36	Out-of-hospital characteristics and care of patients with severe sepsis: a cohort study. ( Band, RA; Cooke, CR; Gaieski, DF; Goss, CH; Hylton, J; Mikkelsen, ME; Rea, TD; Seymour, CW, 2010)
"Six to 24 h after the onset of septic shock, the concentration of lactate in the rectal lumen was estimated by a 4-h equilibrium dialysis."	1.36	Lactate concentrations in the rectal lumen in patients in early septic shock. ( Ibsen, M; Joensen, H; Lauritsen, AØ; Perner, A; Tenhunen, J; Thornberg, K; Waldau, T; Wiis, J, 2010)
"During septic shock, muscle produces lactate and pyruvate by way of an exaggerated Na(+), K(+)-ATPase-stimulated aerobic glycolysis associated with epinephrine stimulation."	1.36	Increased muscle-to-serum lactate gradient predicts progression towards septic shock in septic patients. ( Gerard, A; Gibot, S; Levy, B; Perez, P, 2010)
"The pathogenic role of disseminated intravascular coagulation (DIC) during septic shock is incompletely understood."	1.36	Relation between coagulation/fibrinolysis and lactate in the course of human septic shock. ( Groeneveld, AB; Hack, CE; Hartemink, KJ, 2010)
"Twenty-one septic shock with NE>0."	1.36	Dopexamine Test in septic shock with hyperlactatemia. ( De Soyres, O; Fourcade, O; Genestal, M; Mayeur, N; Mebazaa, A; Minville, V; Salem, R; Vallée, F, 2010)
"We enrolled 37 patients with septic shock who were receiving noradrenaline infusions, and their attending physicians had placed a PA catheter for fluid management."	1.35	Venous oxygen saturation and lactate gradient from superior vena cava to pulmonary artery in patients with septic shock. ( Armaganidis, A; Bonovas, S; Kopterides, P; Kostadima, E; Mavrou, I; Zakynthinos, E, 2009)
"Acute liver failure is often accompanied by hyperdynamic circulation, which is also a characteristic of septic shock."	1.35	Hemodynamics and metabolic studies on septic shock in patients with acute liver failure. ( Chen, PC; Chen, YC; Chu, YY; Fang, JT; Lien, JM; Peng, YS; Tang, JH; Tian, YC; Tsai, MH; Wu, CS; Yang, C, 2008)
"One hundred and five patients with septic shock were admitted, 74 male and 31 female, the mean age was 70 +/- 12 years."	1.35	[Prospective research on the prognosis of septic shock based on the change of lactate concentration in arterial blood]. ( Huang, YZ; Liu, SQ; Mo, M; Qiu, HB; Xie, JF; Yang, CS; Yang, Y, 2009)
"Seventy-two patients with septic shock were studied."	1.35	Lactate, procalcitonin, and amino-terminal pro-B-type natriuretic peptide versus cytokine measurements and clinical severity scores for prognostication in septic shock. ( Koay, ES; Lee, KH; Phua, J, 2008)
"During septic shock, muscle produces lactate by way of an exaggerated NaK-adenosine triphosphatase (ATPase)-stimulated aerobic glycolysis associated with epinephrine stimulation possibly through beta2 adrenoreceptor involvement."	1.35	Increased aerobic glycolysis through beta2 stimulation is a common mechanism involved in lactate formation during shock states. ( Desebbe, O; Gibot, S; Levy, B; Montemont, C, 2008)
"Muscle lactate formation in endotoxic shock was further inhibited by intravenous infusion of ICI-118551 or dichloroacetate (DCA), an activator of pyruvate dehydrogenase (DCA) and their combination."	1.34	Myocardial lactate deprivation is associated with decreased cardiovascular performance, decreased myocardial energetics, and early death in endotoxic shock. ( Gibot, S; Lacolley, P; Lecompte, T; Levy, B; Mallie, JP; Mansart, A; Montemont, C; Regnault, V, 2007)
"Patients with either septic shock or lactate >or=4."	1.34	Occult hypoperfusion and mortality in patients with suspected infection. ( Clardy, P; Donnino, M; Howell, MD; Shapiro, NI; Talmor, D, 2007)
"During a 6-month period, 38 intubated septic shock patients were included in the study."	1.34	The hemodynamic "target": a visual tool of goal-directed therapy for septic patients. ( Fourcade, O; Genestal, M; Marty, P; Samii, K; Sanchez, P; Vallée, F, 2007)
"Neutropenia is a major risk factor for developing a serious infection."	1.34	Predictive factors of septic shock and mortality in neutropenic patients. ( Balkis, M; Hela, BA; Karima, K; Lamia, A; Mohamed, Z; Raihane, B; Ramzi, J; Yosr, B; Zaher, B, 2007)
" More patients received superhigh dosage of norepinephrine or dopamine in the nonsurvivor group."	1.34	[The application of pulmonary artery catheterization in treatment of septic shock patients]. ( Liu, DW; Xie, ZY, 2007)
"In our study, the mortality of severe sepsis and septic shock patients was 38%."	1.33	Evolutive standard base excess and serum lactate level in severe sepsis and septic shock patients resuscitated with early goal-directed therapy: still outcome markers? ( Azevedo, LC; da Cruz Neto, LM; Maciel, AT; Noritomi, DT; Park, M; Pizzo, VR, 2006)
"Nine patients with septic shock and abdominal focus of infection, 7 with severe sepsis and pulmonary focus and 8 healthy subjects."	1.33	Increased colorectal permeability in patients with severe sepsis and septic shock. ( Espersen, K; Jørgensen, VL; Nielsen, SL; Perner, A, 2006)
"In patients with severe sepsis and septic shock, luminal concentrations of L- and D-lactate in the rectum were related to severity of disease and outcome."	1.33	Luminal concentrations of L- and D-lactate in the rectum may relate to severity of disease and outcome in septic patients. ( Jørgensen, VL; Perner, A; Reiter, N, 2006)
"The rat model of septic shock was made by caecal ligation and perforation."	1.32	Effect of ghrelin on septic shock in rats. ( Chang, L; Du, JB; Gao, LR; Pang, YZ; Tang, CS, 2003)
"Recent findings in human septic shock suggest that glucocorticosteroids can limit and even reverse hemodynamic disturbances and dependence on catecholamines."	1.32	Hemodynamic effects of early versus late glucocorticosteroid administration in experimental septic shock. ( Bollaert, PE; Levy, B; Longrois, D; Mallié, JP; Mansart, A; Seguin, C, 2003)
"It appears that in early septic shock, autoregulation of microcirculatory blood flow is largely intact in the intestinal mucosa in anesthetized pigs, explaining why microcirculatory blood flow remained virtually unchanged."	1.32	Redistribution of microcirculatory blood flow within the intestinal wall during sepsis and general anesthesia. ( Banic, A; Hiltebrand, LB; Krejci, V; Sigurdsson, GH; tenHoevel, ME, 2003)
"In this prolonged septic shock model, association of norepinephrine with either dopamine or dobutamine resulted in the longest survival and the least severe pulmonary lesions."	1.32	Optimal adrenergic support in septic shock due to peritonitis. ( De Backer, D; Dimopoulos, G; Lobo, S; Nagy, N; Rogiers, P; Sun, Q; Tu, Z; Vincent, JL, 2003)
"In this acute endotoxic shock model, CVVH with the polyacrylonitrile membrane improved cardiac performance when compared with the polysulphone membrane."	1.32	Comparison of polyacrylonitrile (AN69) and polysulphone membrane during hemofiltration in canine endotoxic shock. ( Pauwels, D; Rogiers, P; Vincent, JL; Zhang, H, 2003)
"The mechanism of gut injury in endotoxic shock seems unrelated to hypoxia and release of nitric oxide."	1.32	Gut mucosal damage during endotoxic shock is due to mechanisms other than gut ischemia. ( De Backer, D; Dimopoulos, G; Lobo, SM; Nagy, N; Preiser, JC; Sun, Q; Terzi, RG; Tu, Z; Vercruy, V; Vincent, JL; Vray, B, 2003)
"Twenty-one pigs were randomized to endotoxin shock (Escherichia coli endotoxin infusion) (n = 6), endotoxin and vasopressin (VASO; n = 6), endotoxin and norepinephrine (NE; n = 6), and controls (n = 3)."	1.32	The effects of vasopressin on systemic and splanchnic hemodynamics and metabolism in endotoxin shock. ( Martikainen, TJ; Ruokonen, E; Tenhunen, JJ; Uusaro, A, 2003)
"Patients with septic shock commonly have myocardial dysfunction associated with lactic acid production and troponin I release."	1.32	Effects of intraaortic balloon augmentation in a porcine model of endotoxemic shock. ( Engoren, M; Habib, RH, 2004)
"Standard criteria were used to diagnose septic shock."	1.32	Diagnostic and prognostic value of procalcitonin in patients with septic shock. ( Clec'h, C; Cohen, Y; Cupa, M; Ferriere, F; Fosse, JP; Hoang, P; Karoubi, P, 2004)
"Septic shock is more severe when of early onset, as reflected by more severe organ dysfunction, greater lactic acidosis, and higher vasopressor requirements, yet the outcome is better, as reflected by a shorter duration of the shock episode, shorter ICU stay, and slightly lower mortality rates."	1.32	Septic shock of early or late onset: does it matter? ( De Backer, D; Melot, C; Orellana-Jimenez, CE; Roman-Marchant, O; Vincent, JL, 2004)
"5 mg) to a patient with severe, hyperdynamic septic shock requiring high dosage of noradrenalin."	1.32	Terlipressin increased the concentration of L-lactate in the rectal lumen in a patient with septic shock. ( Jørgensen, VL; Perner, A; Waldau, T, 2004)
"Since the moribund hypodynamic phase of septic shock has primarily been studied in small animal models, the objective of this study was to investigate the usefulness of infusing Salmonella typhosa endotoxin at incrementing doses to establish an ovine model of hypodynamic endotoxaemia."	1.32	New approach to an ovine model of hypodynamic endotoxaemia. ( Bone, HG; Booke, M; Daudel, F; Sander, J; Stubbe, H; Van Aken, H; Westphal, M, 2004)
"Lactic acidosis is an important complication of septic shock."	1.31	Blood pH level modulates organ metabolism of lactate in septic shock in dogs. ( Bautista, E; Bose, D; Chrusch, C; Duke, K; Jacobs, HK; Light, RB; Mink, SN, 2002)
"Mortality due to gram-negative septic shock remains high despite advances in medical care."	1.31	Prophylactic treatment of endotoxic shock with monophosphoryl lipid A in newborn rats. ( Goto, M; Muraskas, J; Myers, TF; Wy, CA; Young, RI, 2000)
"Dobutamine infusion has been proposed to increase splanchnic blood flow in septic conditions, but its' effects on liver blood flow and metabolism have not been well defined."	1.31	Effects of dobutamine on hepato-splanchnic hemodynamics in an experimental model of hyperdynamic endotoxic shock. ( Borgers, M; Cherkhaoui, S; De Backer, D; Vincent, JL; Zhang, H, 2001)
"Pretreatment with quercetin (200 mg x kg(-1)per os) 2 h before LPS injection diminished the shock-induced increases in brain MDA, and NO(x)levels while elevating the reduced brain phospholipids' and serum SH groups' content."	1.31	Quercetin, coenzyme Q10, and L-canavanine as protective agents against lipid peroxidation and nitric oxide generation in endotoxin-induced shock in rat brain. ( Abd El-Gawad, HM; Khalifa, AE, 2001)
"The incidence of disseminated intravascular coagulation (DIC) was significantly higher in the nonsurvivors than in the survivors."	1.31	Serial measurement of arterial lactate concentrations as a prognostic indicator in relation to the incidence of disseminated intravascular coagulation in patients with systemic inflammatory response syndrome. ( Gando, S; Kemmotsu, O; Kobayashi, S; Morimoto, Y; Nanzaki, S, 2001)
"We report a case of fatal septic shock, with hyperlactatemia and blood cultures positive for Streptococcus pneumoniae, in a 70-year-old patient."	1.30	Increased lactate/pyruvate ratio with normal beta-hydroxybutyrate/acetoacetate ratio and lack of oxygen supply dependency in a patient with fatal septic shock. ( Annat, G; Gallet, D; Goudable, J; Vedrinne, JM; Viale, JP, 1997)
"In a porcine endotoxin shock model, the mixed nonpeptide endothelin receptor antagonist bosentan was administered 2 h after onset of endotoxemia (n = 8)."	1.30	Cardiopulmonary dysfunction during porcine endotoxin shock is effectively counteracted by the endothelin receptor antagonist bosentan. ( Alving, K; Oldner, A; Rudehill, A; Sollevi, A; Wanecek, M; Weitzberg, E, 1997)
"Like hemorrhagic shock, highly significant linear correlations were observed between end-tidal PCO2 and cardiac index and between sublingual PCO2 and arterial blood lactate."	1.30	Sublingual capnometry for diagnosis and quantitation of circulatory shock. ( Bisera, J; Jin, X; Nakagawa, Y; Sun, S; Tang, W; Weil, MH; Yamaguchi, H, 1998)
"During endotoxic shock increased cardiac output achieved by colloid infusion maintained elevated liver blood flow and thereby macro- and microcirculatory O2 supply."	1.30	Effect of increased cardiac output on liver blood flow, oxygen exchange and metabolic rate during longterm endotoxin-induced shock in pigs. ( Adler, J; Georgieff, M; Iber, T; Radermacher, P; Rieger, KM; Santak, B; Träger, K; Vogt, J; Wachter, U, 1998)
"Endotoxic shock was induced by intravenous injection of 3 mg/kg of E."	1.30	Effects of dobutamine, norepinephrine and epinephrine on intramucosal pH and hemodynamics of dogs during endotoxic shock. ( Hayes, JK; Luo, X; McJames, S; Tseng, CK; Wong, KC, 1998)
"Fifteen consecutive patients with septic shock and six mechanically ventilated patients without septic shock."	1.30	Myocardial cell injury in septic shock. ( Bellomo, R; Tsamitros, M; Turner, A, 1999)
"In this acute endotoxic shock model, CWH at 3 Uhr improved cardiac performance and decreased pulmonary vasoconstriction."	1.30	Continuous venovenous hemofiltration improves cardiac performance by mechanisms other than tumor necrosis factor-alpha attenuation during endotoxic shock. ( Pauwels, D; Rogiers, P; Smail, N; Vincent, JL; Zhang, H, 1999)
"Peritonitis was induced in Sprague-Dawley rats by cecal ligation and fecal spillage."	1.29	Gastric intramural PCO2 during peritonitis and shock. ( Bisera, J; Desai, VS; Tang, W; Weil, MH; Yang, G, 1993)
"These data suggest that diltiazem treatment in endotoxic shock improves hypoglycemia and attenuates hyperlacticacidemia."	1.29	Effect of diltiazem on altered glucose regulation during endotoxic shock. ( Geller, ER; Maitra, SR; Pan, W, 1993)
"Ibuprofen pretreatment alone or dual blockade (ibuprofen plus LY203647) protected blood pressure and renal blood flow at 1 and 3 hr after endotoxin infusion."	1.29	Effectiveness of dual cyclooxygense and leukotriene blockade with ibuprofen and LY203647 during canine endotoxic shock. ( Jimenez, AE; Passmore, JC, 1993)
"In 87 patients with a first episode of septic shock, we measured initial lactate (at onset of septic shock), final lactate (before recovery or death), "lactime" (time during which blood lactate was > 2."	1.29	Serial blood lactate levels can predict the development of multiple organ failure following septic shock. ( Bakker, J; Coffernils, M; Gris, P; Kahn, RJ; Vincent, JL, 1996)
"During endotoxin shock mean arterial pressure (MAP) and cardiac output (CO) fall, and the latter is redistributed."	1.29	The fall of cardiac output in endotoxemic rats cannot explain all changes in organ blood flow: a comparison between endotoxin and low venous return shock. ( Mulder, MF; Thijs, LG; van den Bos, GC; van Lambalgen, AA, 1996)
"38 hospitalized patients with septic shock, including 18 survivors and 20 non-survivors."	1.29	Blood lactate levels are better prognostic indicators than TNF and IL-6 levels in patients with septic shock. ( Dupont, E; Kahn, RJ; Marecaux, G; Pinsky, MR; Vincent, JL, 1996)
"Sepsis and septic shock continue to have a high mortality and morbidity in the newborn."	1.29	Perinatal nutrition enriched with omega-3 polyunsaturated fatty acids attenuates endotoxic shock in newborn rats. ( Anderson, CL; Farolan, LR; Goto, M; Myers, TF; Zeller, WP, 1996)
"Ibuprofen pretreatment increases arterial pressure and reduces mortality in endotoxic dogs."	1.28	Cardiovascular response in canine endotoxic shock: effect of ibuprofen pretreatment. ( Pinsky, MR, 1992)
"Diltiazem treatment resulted in reduced 24-hour mortality."	1.28	Diltiazem treatment of endotoxic shock in suckling rats. ( Goto, M; Hurley, RM; Lichtenberg, RC; Zeller, WP, 1992)
"In patients with cirrhosis, septic shock was characterized by severe liver dysfunction, low blood temperature, marked increases in cardiac index and lactic acidemia, and a 100% ICU mortality rate."	1.28	Septic shock in patients with cirrhosis: hemodynamic and metabolic characteristics and intensive care unit outcome. ( Assous, M; Hadengue, A; Kirstetter, P; Mamzer, MF; Moreau, R; Sicot, C; Soupison, T; Vanjak, D; Vauquelin, P, 1992)
"Hemorrhage was initiated at t = 0 min or t = 70 min in groups I and II, respectively."	1.28	Systemic and mesenteric O2 metabolism in endotoxic pigs: effect of graded hemorrhage. ( Baum, TD; Fink, MP; Heard, SO; Rothschild, HR; Wang, HL, 1991)
"In 22 patients, 14 with septic shock and 8 post-operative controls, oxygen delivery was increased by increasing cardiac output with vasodilation by phentolamine, during a total of 207 days."	1.28	Delivery dependent oxygen consumption in patients with septic shock: daily variations, relationship with outcome and the sick-euthyroid syndrome. ( Palazzo, MG; Suter, PM, 1991)
"Transient hyperinsulinemia has been incriminated as a contributing factor to endotoxin-induced hypoglycemia."	1.27	Persistent hyperinsulinemia due to induced euglycemia in awake endotoxic minipigs. ( Chandrasena, LG; Cleek, JL; Fettman, MJ; Hand, MS; Mason, RA; Phillips, RW, 1984)
"The influence of anesthesia on endotoxin shock patterns in the rat was examined."	1.27	Anesthetic-induced changes in cardiovascular and small intestinal responses to endotoxin in the rat. ( Brackett, DJ; Schaefer, CF; Tompkins, P; Wilson, MF, 1984)
"Lactic acid levels were significantly increased and arterial bicarbonate levels were reduced by six hours in all groups except for group 4."	1.27	The efficacy of dexamethasone and flunixin meglumine in treating endotoxin-induced changes in calves. ( Bottoms, GD; Fessler, JF; Margolis, JH, 1987)
"Nineteen patients had nonseptic shock (NSS), and 31 had septic shock (SS)."	1.27	Relation of arterial blood lactate to oxygen delivery and hemodynamic variables in human shock states. ( Groeneveld, AB; Kester, AD; Nauta, JJ; Thijs, LG, 1987)
"It is well established that septic shock is caused by Gram-negative endotoxemia, and is characterized by hyperdynamic state being observed in the early stage of shock."	1.27	[Hyperdynamic state induced by continuous infusion of E. coli endotoxin in dogs]. ( Wu, TT, 1985)
"We conclude that during endotoxin shock 1) the increased demands of the respiratory muscles are met by increasing blood flow and O2 extraction; 2) anaerobic metabolism and respiratory muscle substrate depletion, or both, may contribute to the observed fatigue."	1.27	Respiratory muscle energetics during endotoxic shock in dogs. ( Graham, R; Hussain, SN; Roussos, C; Rutledge, F, 1986)
"When histamine was administered to endotoxic animals, it failed to produce effects other than those caused by endotoxin alone."	1.26	Adenine nucleotide and lactate metabolism in the lung in endotoxin shock. ( Murthy, PN; Sayeed, MM, 1981)

Research

Studies (508)

Authors

Clinical Trials (65)

Trial Overview

Trial Outcomes

Change in Lactate Level

Timeframe	Studies, this research(%)	All Research%
pre-1990	37 (7.28)	18.7374
1990's	78 (15.35)	18.2507
2000's	89 (17.52)	29.6817
2010's	207 (40.75)	24.3611
2020's	97 (19.09)	2.80

Authors	Studies
Arina, P	1
Moro, V	1
Baso, B	1
Baxter-Derrington, C	1
Singer, M	2
Weinberger, J	1
Klompas, M	4
Rhee, C	2
Hiraiwa, H	1
Kasugai, D	1
Ozaki, M	1
Goto, Y	1
Jingushi, N	1
Higashi, M	1
Nishida, K	1
Kondo, T	1
Furusawa, K	1
Morimoto, R	1
Okumura, T	1
Matsuda, N	1
Matsui, S	1
Murohara, T	1
Sacha, GL	1
Lam, SW	1
Wang, L	1
Duggal, A	1
Reddy, AJ	1
Bauer, SR	1
Kim, SM	1
Ryoo, SM	6
Shin, TG	10
Park, YS	1
Jo, YH	5
Lim, TH	3
Chung, SP	5
Choi, SH	6
Suh, GJ	5
Kim, WY	9
Evans, L	2
Rhodes, A	3
Alhazzani, W	3
Antonelli, M	3
Coopersmith, CM	2
French, C	2
Machado, FR	2
Mcintyre, L	2
Ostermann, M	2
Prescott, HC	2
Schorr, C	2
Simpson, S	2
Wiersinga, WJ	1
Alshamsi, F	2
Angus, DC	3
Arabi, Y	2
Azevedo, L	2
Beale, R	2
Beilman, G	2
Belley-Cote, E	2
Burry, L	2
Cecconi, M	5
Centofanti, J	2
Coz Yataco, A	1
De Waele, J	2
Dellinger, RP	4
Doi, K	2
Du, B	2
Estenssoro, E	7
Ferrer, R	2
Gomersall, C	2
Hodgson, C	2
Hylander Møller, M	1
Iwashyna, T	2
Jacob, S	2
Kleinpell, R	2
Koh, Y	6
Kumar, A	9
Kwizera, A	2
Lobo, S	3
Masur, H	2
McGloughlin, S	2
Mehta, S	3
Mehta, Y	2
Mer, M	2
Nunnally, M	2
Oczkowski, S	2
Osborn, T	2
Papathanassoglou, E	2
Perner, A	13
Puskarich, M	2
Roberts, J	2
Schweickert, W	2
Seckel, M	2
Sevransky, J	2
Sprung, CL	3
Welte, T	2
Zimmerman, J	2
Levy, M	2
Yeo, HJ	1
Lee, YS	3
Kim, TH	1
Jang, JH	3
Lee, HB	1
Oh, DK	1
Park, MH	1
Lim, CM	5
Cho, WH	1
Nedel, WL	1
Strogulski, NR	1
Kopczynski, A	1
Rodolphi, MS	1
Montes, THM	1
Júnior, JA	1
Friedman, G	5
Portela, LV	1
Huang, W	4
Wang, X	9
Xie, F	2
Zhang, H	10
Liu, D	5
Joost Wiersinga, W	1
Yataco, AC	3
Møller, MH	2
Warstadt, NM	1
Caldwell, JR	1
Tang, N	1
Mandola, S	1
Jamin, C	1
Dahn, C	1
Powell, ES	1
Bond, WF	1
Barker, LT	1
Cooley, K	1
Lee, J	3
Vincent, AL	1
Vozenilek, JA	1
Guarino, M	1
Perna, B	1
De Giorgi, A	1
Gambuti, E	1
Alfano, F	1
Catanese, EM	1
Volpato, S	1
Strada, A	1
Caio, G	1
Contini, C	1
De Giorgio, R	1
Wu, Y	2
Yu, C	1
Zhou, Y	2
He, ZM	1
Zhang, W	1
Fan, J	1
Sun, Y	1
Yoon, SH	1
Choi, B	1
Eun, S	1
Bae, GE	1
Koo, CM	1
Kim, MK	1
He, Z	2
Yang, X	2
Yang, C	3
Wang, R	1
He, H	3
Lorente, L	3
Martín, MM	3
Ortiz-López, R	3
González-Rivero, AF	3
Gómez-Bernal, F	2
González-Mesa, A	2
Jiménez, A	3
Pérez-Cejas, A	3
Maiwall, R	2
Pasupuleti, SSR	1
Hidam, AK	1
Tevethia, H	1
Kumar, G	2
Sahney, A	1
Mitra, LG	1
Sarin, SK	2
El-Nawawy, AA	1
Hassaan, SM	1
Hassouna, HM	1
Patel, S	1
Puri, N	1
Cuenca, JA	1
Manjappachar, NK	1
Ramírez, CM	1
Hernandez, M	1
Martin, P	1
Gutierrez, C	1
Rathi, N	1
Price, KJ	1
Nates, JL	1
Xie, J	2
Xiao, W	1
Lin, J	1
Liu, J	3
Zhou, G	2
Chen, R	2
Tong, Z	2
Su, GY	1
Fan, CN	1
Fang, BL	1
Xie, ZD	1
Qian, SY	1
Shadvar, K	2
Nader-Djalal, N	1
Vahed, N	1
Sanaie, S	1
Iranpour, A	1
Mahmoodpoor, A	2
Vahedian-Azimi, A	1
Samim, A	1
Rahimi-Bashar, F	1
Lee, HJ	2
Ko, BS	3
Han, E	1
Kwon, WY	2
Hwang, SY	7
Shin, J	1
Kim, K	2
Li, S	1
Shen, Y	1
Chang, B	1
Wang, N	1
Cereuil, A	1
Ronflé, R	1
Culver, A	1
Boucekine, M	1
Papazian, L	1
Lefebvre, L	1
Leone, M	3
Çeleğen, M	1
Çeleğen, K	1
Honore, PM	2
Redant, S	1
Djimafo, P	1
Blackman, S	1
Preseau, T	1
Cismas, BV	1
Kaefer, K	1
Barreto Gutierrez, L	1
Anane, S	1
Gallerani, A	1
Attou, R	1
Zhang, LT	1
Xu, X	1
Han, H	1
Cao, SM	1
Li, LL	1
Lv, J	1
Zhang, LR	1
Li, JG	2
Wu, C	1
Ouyang, L	1
Peng, Y	1
Zhong, D	1
Xiang, X	1
Li, J	3
Onoe, A	1
Muroya, T	1
Nakamura, F	1
Ikegawa, H	1
Kuwagata, Y	1
Kobayakawa, R	1
Kobayakawa, K	1
Ferrer-Moure, C	1
Van Moorter, N	3
Tackaert, T	3
De Decker, K	3
Van Vlem, B	3
De Neve, N	3
Pandey, S	3
Siddiqui, MA	3
Azim, A	3
Sinha, N	3
Gonçalves-Ferri, WA	3
Albuquerque, AAS	3
de Castro, RSAP	3
Ferreira, CHF	3
Oharomari, LK	3
Silva Lessa, DF	3
Evora, PRB	3
Schneider, L	3
Chalmers, D	3
O'Beirn, S	3
Greenberg, M	3
Cave, G	4
Lee, JH	4
Kim, SH	2
Park, JH	2
Jo, KM	2
No, TH	2
Jang, HJ	2
Lee, HK	2
Bloos, F	2
Blakeslee, PA	1
Hyrkäs, K	1
Kanjee, Z	1
Berg, K	1
Bell, TD	1
Reynolds, EE	1
Sterk, E	1
Wassermann, T	1
Lamonge, R	1
Semenchuck, N	1
Rech, MA	1
Yuniar, I	1
Fitriasari, R	1
Prawira, Y	1
Handryastuti, S	1
Kadim, M	1
Triratna, S	1
Djer, MM	1
Kuttab, HI	1
Evans, CG	1
Lykins, JD	1
Hughes, MD	1
Kopec, JA	1
Hernandez, MA	1
Ward, MA	1
Wang, C	4
Zhang, C	2
Hu, W	1
Chen, H	3
Ma, C	1
Sun, Q	4
Yang, M	1
Wang, H	5
Peng, Q	1
Wang, J	3
Huang, Y	1
Turan, YB	1
Messmer, A	1
Pietsch, U	1
Siegemund, M	1
Buehler, P	1
Waskowski, J	1
Müller, M	1
Uehlinger, DE	1
Hollinger, A	1
Filipovic, M	1
Berger, D	1
Schefold, JC	1
Pfortmueller, CA	1
Wang, G	1
Zong, H	1
Shang, X	1
Chen, T	1
Wang, Y	4
Ren, Y	1
Jiang, Y	1
Li, Y	3
Lv, Q	1
Liu, P	2
Liao, J	1
Qin, C	1
Wang, Z	3
Gao, L	1
Zhang, S	1
Feng, Y	1
Tao, L	1
Garcia, B	1
Su, F	5
Dewachter, L	1
Li, N	1
Remmelink, M	1
Eycken, MV	1
Khaldi, A	1
Favory, R	2
Herpain, A	3
Moreau, A	1
Moiroux-Sahraoui, A	1
Manicone, F	1
Annoni, F	1
Shi, L	1
Vincent, JL	24
Creteur, J	4
Taccone, FS	5
Chen, X	1
Wei, H	2
Chen, F	1
Hu, Y	1
Zampieri, FG	1
Damiani, LP	2
Bakker, J	11
Ospina-Tascón, GA	4
Castro, R	6
Cavalcanti, AB	3
Hernandez, G	12
Contenti, J	2
Occelli, C	2
Lemoel, F	2
Ferrari, P	1
Levraut, J	2
Haan, BJ	1
Cadiz, ML	1
Natavio, AM	1
Postelnicu, R	1
Mukherjee, V	1
Okonkwo, E	1
Rozario, N	1
Heffner, AC	2
Ahmed, RM	1
Soliman, AR	1
Yousry, A	1
Marzouk, K	1
Faris, F	1
Weiss, SL	2
Peters, MJ	2
Agus, MSD	1
Flori, HR	2
Inwald, DP	1
Nadel, S	2
Schlapbach, LJ	3
Tasker, RC	1
Argent, AC	1
Brierley, J	1
Carcillo, J	1
Carrol, ED	2
Carroll, CL	1
Cheifetz, IM	1
Choong, K	1
Cies, JJ	1
Cruz, AT	1
De Luca, D	2
Deep, A	1
Faust, SN	1
De Oliveira, CF	1
Hall, MW	1
Ishimine, P	1
Javouhey, E	2
Joosten, KFM	1
Joshi, P	1
Karam, O	1
Kneyber, MCJ	1
Lemson, J	1
MacLaren, G	3
Mehta, NM	1
Newth, CJL	1
Nguyen, TC	1
Nishisaki, A	1
Nunnally, ME	1
Parker, MM	2
Paul, RM	1
Randolph, AG	1
Ranjit, S	1
Romer, LH	1
Scott, HF	1
Tume, LN	1
Verger, JT	1
Williams, EA	1
Wolf, J	1
Wong, HR	1
Zimmerman, JJ	1
Kissoon, N	1
Tissieres, P	2
Alam, A	1
Gupta, S	1
Seok, H	1
Song, J	3
Jeon, JH	1
Choi, HK	1
Choi, WS	1
Moon, S	2
Park, DW	2
Blet, A	1
de Roquetaillade, C	1
Hartmann, O	1
Struck, J	1
Mebazaa, A	2
Chousterman, BG	1
Khodashahi, R	1
Sarjamee, S	1
Shu, W	1
Wan, J	1
Chen, J	2
He, W	2
Zhu, Y	2
Zeng, H	1
Xia, L	1
Lu, N	1
Andrés, C	1
Andaluz-Ojeda, D	1
Cicuendez, R	1
Nogales, L	1
Martín, S	1
Martin-Fernandez, M	1
Almansa, R	1
Calvo, D	1
Esteban-Velasco, MC	1
Vaquero-Roncero, LM	1
Ríos-Llorente, A	1
Sanchez-Barrado, E	1
Muñoz-Bellvís, L	1
Aldecoa, C	1
Bermejo-Martin, JF	1
Osborn, TM	1
Young, PJ	1

Trial	Phase	Enrollment	Study Type	Start Date	Status
A Multi-Center, Randomized, Controlled, Pivotal Study to Assess the Safety and Efficacy of a Selective Cytopheretic Device in Patients With Acute Kidney Injury Requiring Continuous Kidney Replacement Therapy[NCT05758077]		200 participants (Anticipated)	Interventional	2023-04-17	Recruiting
Impact of Thiamine Supplementation on Mortality in Septic Shock. A Controlled Before-and-after Study.[NCT05840718]		80 participants (Anticipated)	Observational	2023-09-30	Not yet recruiting
Risk Factors for Multidrug Resistant Bacteria at ICU Admission[NCT05983861]		400 participants (Anticipated)	Observational	2023-09-01	Not yet recruiting
Incidence of Hypotension in the Weaning From Vasopressor Drugs[NCT05506319]		78 participants (Anticipated)	Interventional	2022-04-04	Recruiting
Assessing Baseline Cortisol Levels in Patients Admitted With Septic Shock in Intensive Care Unit; A Single Centre Real World Study.[NCT05741762]		50 participants (Anticipated)	Observational	2023-01-31	Recruiting
Comparison of Colloid (20% Albumin) Versus Crystalloid (Plasmalyte) for Fluid Resuscitation in Cirrhotics With Sepsis Induced Hypotension.[NCT02721238]		100 participants (Actual)	Interventional	2016-12-01	Completed
Septic Shock Management Guided by Ultrasound: A Randomized Control Trial (SEPTICUS Trial)[NCT04728529]		340 participants (Anticipated)	Interventional	2021-09-02	Recruiting
Randomized Controlled Trial of Dopamine, Adrenaline, and Blood Transfusion for Treatment of Fluid Refractory Shock in Children With Severe Acute Malnutrition or Severe Underweight and Cholera or Other Dehydrating Diarrheas[NCT04750070]	Phase 3	135 participants (Anticipated)	Interventional	2021-08-17	Recruiting
Reducing Empiric VAncomycin Use in Pediatric Suspected Sepsis (REVAMP-Sepsis)[NCT05975671]		52,500 participants (Anticipated)	Interventional	2023-08-21	Recruiting
Fluids in Sepsis and Septic Shock: A Pilot Randomized Controlled Trial[NCT02748382]	Phase 2/Phase 3	50 participants (Actual)	Interventional	2016-08-18	Completed
Hemodynamic Assessment With Transpulmonary Thermodilution and Transesophageal Echocardiography in Patients With Early Septic Shock[NCT01188993]	Phase 4	153 participants (Actual)	Interventional	2011-01-31	Completed
Resuscitation Failure, Protein Carbonyl and Receptor Interacting Protein Kinase 3 as Mortality Predictor in Septic Patient[NCT04169412]		72 participants (Actual)	Observational [Patient Registry]	2019-02-22	Completed
Mortality Due to Septic Shock Associated With Thrombocytopenia in the Intensive Care Unit[NCT03617965]		350 participants (Anticipated)	Observational	2018-08-15	Active, not recruiting
Venoarterial PCO2 Difference /Arteriovenous O2 Content Difference Ratio as Goal of Early Severe Sepsis and Septic Shock Therapy[NCT01877798]		300 participants (Anticipated)	Interventional	2013-06-30	Not yet recruiting
Effect of Personalized Hemodynamic Management Based on Serum Renin Concentration on Acute Kidney Injury Progression in Patients With Shock: a Randomized Controlled Trial.[NCT05898126]		800 participants (Anticipated)	Interventional	2023-06-05	Not yet recruiting
Influence of Vasopressor Support and Mean Arterial Pressure on Capillary Refill Time Values in Critically Ill Patients: Prospective, Observational Study[NCT05674084]		150 participants (Anticipated)	Observational	2022-12-03	Recruiting
Capillary Refill Time Response to a Rapid Fluid Challenge in Septic Shock Patients: Pathophysiological Determinants, and Relation to Changes in Systemic, Regional and Microcirculatory Blood Flow[NCT04693923]		42 participants (Anticipated)	Interventional	2021-02-01	Not yet recruiting
Effect of Vasopressin on Kidney and Cardiac Function in Previously Hypertensive Patients With Septic Shock: A Randomized Clinical Trial[NCT06125184]		50 participants (Anticipated)	Interventional	2022-11-01	Recruiting
Early Goal Directed Therapy Using a Physiological Holistic View. A Multicenter Study in Latin America: The ANDROMEDA-SHOCK Study[NCT03078712]		424 participants (Actual)	Interventional	2017-03-01	Completed
Peripheral Perfusion Versus Lactate Targeted Fluid Resuscitation in Septic Shock: ANDROMEDA-SHOCK PHYSIOLOGY STUDY[NCT03762005]		46 participants (Anticipated)	Interventional	2018-06-01	Recruiting
Contribution of Capillary Refilling Time and Skin Mottling Score to Predict Intensive Care Unit Admission of Patients With Septic or Haemorrhagic Shock Admitted to the Emergency Department[NCT03831022]		1,500 participants (Anticipated)	Observational [Patient Registry]	2018-12-17	Recruiting
To Assess and Validate the Use of MR-proADM and the CT-proET-1/MR-proADM Ratio as Prognostic Markers During the First 7 Days of ICU Treat-ment[NCT03651635]		533 participants (Actual)	Observational	2018-01-08	Completed
Capillary Refill Index Measurement With a Temperature Control Procedure[NCT04366310]		65 participants (Actual)	Observational	2020-11-16	Terminated (stopped due to Insufficient enrollment to achieve outcomes)
Develop, Implement and Assess Effectiveness of Early Warning Score (EWS) for Moneragala District General Hospital[NCT02523456]		18,000 participants (Actual)	Interventional	2015-05-01	Completed
Medical Education for Sepsis Source Control and Antibiotics[NCT01187134]		4,138 participants (Actual)	Interventional	2011-07-31	Completed
RApid Fluid Volume EXpansion (RVE) in Critically Ill Patients With Acute Circulatory Failure After the Initial Phase of Resuscitation. A Single-center, Open-label, Randomized Study Comparing 3 Strategies of RVE in Orléans, France.[NCT02645851]		135 participants (Anticipated)	Interventional	2016-01-16	Recruiting
Using the ΔvapCO2 / Cav02 Ratio as a Prognostic Marker and Predictor of Complications After Cardiac Surgery[NCT02876406]		150 participants (Anticipated)	Observational [Patient Registry]	2016-10-31	Recruiting
Comparison of the Predictive and Prognostic Value of Cellular Dysoxia Markers in the Postoperative Period of Cardiac Surgery With Extracorporeal Circulation[NCT03107572]		330 participants (Actual)	Observational	2016-06-30	Completed
C-Reactive Protein / Albumin Ratio as a Predictive Inflammatory Marker for Postoperative Systemic Inflammatory Response Syndrome and/or Sepsis in Polytraumatized Patients in ICU[NCT06050759]		100 participants (Anticipated)	Observational	2023-10-01	Not yet recruiting
A Phase II Double Blind Randomized Controlled Trial of High Dose Vitamin B12 in Septic Shock[NCT03783091]	Phase 2	20 participants (Anticipated)	Interventional	2019-08-05	Recruiting
Critical Care Ultrasound Oriented Shock Treatment in ICU[NCT03093987]		150 participants (Actual)	Interventional	2017-04-05	Completed
The Thiamine Administration After Cardiac Surgery Trial[NCT04641104]	Phase 4	200 participants (Actual)	Interventional	2020-11-20	Completed
Thiamine as a Renal Protective Agent in Septic Shock: A Randomized, Controlled Study[NCT03550794]	Phase 2	95 participants (Actual)	Interventional	2018-09-04	Completed
Evaluation of Hydrocortisone, Vitamin C and Thiamine for the Treatment of Septic Shock[NCT03380507]	Phase 2/Phase 3	106 participants (Actual)	Interventional	2018-03-17	Terminated (stopped due to The research is no longer funded and terminated due to futility)
Outcomes of Metabolic Resuscitation Using Ascorbic Acid, Thiamine, and Glucocorticoids in the Early Treatment of Sepsis.[NCT03422159]	Phase 2	140 participants (Actual)	Interventional	2018-02-05	Completed
Ascorbic Ccid, Hydrocortisone, and Thiamine in Sepsis and Septic Shock - A Randomized, Double-Blind, Placebo-Controlled Trial[NCT03389555]	Phase 2/Phase 3	205 participants (Actual)	Interventional	2018-02-09	Completed
Combination Therapy of Vitamin C and Thiamine for Septic Shock: Multi-center, Double-blinded, Randomized, Controlled Study[NCT03756220]	Phase 2	116 participants (Actual)	Interventional	2018-12-01	Completed
A Randomized, Double Blind, Placebo-Controlled Study to Investigate the Effects of Vitamin C, Hydrocortisone and Thiamine on the Outcome of Patients With Severe Sepsis and Septic Shock[NCT03335124]	Phase 4	5 participants (Actual)	Interventional	2017-09-26	Terminated (stopped due to Due to insufficient recruitment)
L-Carnitine Administration in Early Sepsis[NCT01193777]	Phase 1	31 participants (Actual)	Interventional	2010-09-30	Terminated (stopped due to Study stopped to open expanded phase II study)
To Compare the Effectiveness of Various Methods of Estimating Volume Resuscitation in Patients With Cirrhosis With Sepsis Induced Hypotension[NCT05059795]		75 participants (Anticipated)	Observational	2020-02-01	Recruiting
Dexmedetomidine Improve Microcirculatory Alterations in Initial Resuscitated Septic Shock Patients[NCT02270281]	Phase 4	44 participants (Actual)	Interventional	2014-12-31	Completed
Targeted Tissue Perfusion Versus Macrocirculatory-guided Standard Care in Patients With Septic Shock [TARTARE-2S]- A Multicentre Randomized Controlled Trial[NCT02579525]		200 participants (Actual)	Interventional	2016-05-31	Completed
A Prospective Open Label Randomized Non Inferiority Trial to Compare the Efficacy and Safety of Monotherapy With Noradrenaline and Terlipressin in Patients of Cirrhosis With Septic Shock Admitted to Intensive Care Unit.[NCT01836224]		84 participants (Actual)	Interventional	2012-10-31	Completed
An Observational Cohort Study to Validate SEARCH, a Novel Hierarchical Algorithm to Define Long-term Outcomes After Pulmonary Embolism[NCT05568927]		150 participants (Anticipated)	Observational	2022-11-01	Enrolling by invitation
Transcutaneous-Arterial Carbon Dioxide Gradient Predicts Microcirculatory Dysfunction And The Development of Organ Failure After Cardiac Surgery[NCT02328846]		0 participants (Actual)	Observational	2018-01-31	Withdrawn (stopped due to Insufficient equipment)
Lactate Assessment in the Treatment of Early Sepsis: The LactATES Trial[NCT00372502]		300 participants (Actual)	Interventional	2007-01-31	Completed
Clinical Study of Central Venous-to-Arterial Carbon Dioxide Difference(Pcv-aCO2) in the Evaluation of Fluid Therapy for Postoperative Patients With Abdominal Cancer[NCT02977429]		150 participants (Anticipated)	Interventional	2016-10-31	Recruiting
Emergency Department (ED) Flow-directed Fluid Optimization Resuscitation Trial (EFFORT)[NCT01128413]		22 participants (Actual)	Interventional	2010-07-31	Terminated (stopped due to lack of resources)
Assessing Targeted Fluid Resuscitation Strategies Among Patients With Severe Sepsis and Septic Shock[NCT03137446]		113 participants (Actual)	Interventional	2017-04-20	Completed
Lactate Clearance and Mortality in Patients With Severe Sepsis and Septic Shock: Comparison by Hepatic Dysfunction[NCT01709565]		245 participants (Anticipated)	Observational	2012-07-31	Recruiting
Does the Concentration of L-Lactate in the Rectum Correlate With Mortality and Morbidity in Patients With Septic Shock?[NCT00197938]		130 participants (Actual)	Observational	2005-11-30	Completed
Comparing Cytokines, Toxins Adsorbing oXiris Filter to ST150 Filter During CRRT in Patients With Septic Shock[NCT02600312]		16 participants (Actual)	Interventional	2015-10-31	Completed
Heparin Binding Protein (HBP) in Sepsis for the Prediction of Disease Progression[NCT02533011]		1,055 participants (Actual)	Observational	2015-07-31	Completed
Markers of Tissue Perfusion as Predictors of Complicated Evolution in Patients With Left Ventricular Dysfunction Submitted to Coronary Artery Bypass Surgery[NCT01178866]		87 participants (Actual)	Observational	2006-01-31	Completed
Fluid Resuscitation Optimization in Surgical Trauma Patients (FROST)[NCT02742974]		196 participants (Anticipated)	Interventional	2015-12-31	Recruiting
EMS Prehospital Blood Culture Collection and Antibiotic Administration: A Two-Phase Pilot Project to Reduce Mortality in Patients With Severe Sepsis and Septic Shock[NCT04134624]		215 participants (Actual)	Interventional	2019-09-11	Terminated (stopped due to Recruitment for this study was halted in February 2020 due to the COVID-19 pandemic. The study team was unable to continue enrollment due to decreased volumes (and the fact that COVID-19 mimics some of the signs and symptoms of severe sepsis))
Analysis of Lactate Monitoring Requirement in Emergent Surgical Interventions in Noncritical Traumatic Long Bone Fractures[NCT05611398]		164 participants (Actual)	Observational	2021-01-01	Completed
Contribution of Pre-hospital Blood Lactate Level for Pre-hospital Orientation of Septic Shock[NCT03831685]		1,000 participants (Anticipated)	Observational	2018-03-01	Recruiting
Energy MEtabolism of Septic Heart.[NCT05202938]		32 participants (Anticipated)	Observational	2022-07-21	Recruiting
Impact of a Continuous Dialysis Technique Associated With Adsorption Capacity Membranes in Patients With Sepsis Associated - Acute Kidney Injury.[NCT01790620]		110 participants (Actual)	Interventional	2013-05-31	Completed
"Influence of High Vitamin C Dose on Lactate During Extracorporeal Circulation for Heart Surgery and During the 24 Hours Thereafter. (Double Blind Prospective Randomised Study)"[NCT04046861]		200 participants (Anticipated)	Interventional	2023-02-01	Not yet recruiting
The American Burn Association's Randomized Controlled Evaluation of Hemofiltration in Adult Burn Patients With Septic Shock and Acute Renal Failure[NCT01213914]		37 participants (Actual)	Interventional	2011-08-31	Active, not recruiting
Vasopressin Plasma Concentrations in Responders and Non-responders to Exogenous Vasopressin Infusion in Patients With Septic Shock[NCT03014063]		18 participants (Actual)	Observational	2016-11-30	Completed
Use of Arginine Vasopressin in Early Postoperative Management After Fontan Palliation[NCT03088345]	Phase 2/Phase 3	20 participants (Actual)	Interventional	2017-03-06	Completed
To Compare 20% Albumin vs. Balanced Salt Solution as Resuscitation Fluid and Identify Fluid Responsiveness Criteria in Critically Ill Patients With Cirrhosis With Sepsis Induced Hypotension; a Prospective Randomized Controlled Trial.[NCT05441878]	Phase 4	150 participants (Anticipated)	Interventional	2020-08-15	Recruiting
[information is prepared from clinicaltrials.gov, extracted Sep-2024]

Change in lactate level between enrollment and 72 hours after enrollment (NCT03550794)
Timeframe: From time of enrollment until 72 hours after enrollment

Change in the Sequential Organ Failure Assessment Score

Intervention	mmol/L (Median)
Thiamine	1.65
Placebo	1.95

Change in Sequential Organ Failure Assessment Score (SOFA) score between enrollment and 72 hours after enrollment. SOFA scores are reported on a scale between 0-24, with 0 representing best outcome and 24 representing worst outcome. (NCT03550794)
Timeframe: Time of enrollment until 72 hours after enrollment

ICU Free Days

Intervention	units on a scale (Mean)
Thiamine	8.09
Placebo	9.61

Days alive and free of the ICU through day 28 (NCT03550794)
Timeframe: From date of enrollment until 28 days after enrollment

In-hospital Mortality

Intervention	days (Median)
Thiamine	22.5
Placebo	0.0

Length of hospital stay truncated at 60 days (NCT03550794)
Timeframe: From date of enrollment until discharge from the hospital or date of death, whichever comes first, up to 60 days after enrollment

Kidney Injury Biomarker

Number of Participants Experiences Acute Renal Failure

Intervention	Participants (Count of Participants)
Thiamine	15
Placebo	25

Intervention	mg/dL (Mean)
Thiamine	2.24
Placebo	2.79

Acute renal failure as defined by the KDIGO (Kidney Disease Improving Global Outcomes) AKI (Acute Kidney Injury) criteria. In brief, a patient can meet these criteria if their serum creatinine increases (for example, serum creatinine increases to 1.5x or higher of baseline serum creatinine, or if it crosses 4mg/dL), or if renal replacement therapy is initiated, or if urine output decreases (for example, <0.5ml/kg/hour for 6-12 hours) or if patient becomes anuric (no urine production). (NCT03550794)
Timeframe: From date of enrollment until day of discharge from the index ICU admission or date of death, whichever comes first up until 60 days post-enrollment

Number of Participants Receiving Renal Replacement Therapy

Intervention	Participants (Count of Participants)
Thiamine	23
Placebo	34

Number of participants who received renal replacement therapy in thiamine and placebo groups. (NCT03550794)
Timeframe: From date of enrollment until discharge from the intensive care unit (ICU) or date of death, whichever comes first, up to 60 days after enrollment

Number of Participants With Delirium on Day 3

Intervention	Participants (Count of Participants)
Thiamine	6
Placebo	10

Number of Participants with Delirium on Day 3 after enrollment (NCT03550794)
Timeframe: Day 3 after enrollment

Novel Biomarkers of Renal Injury

Intervention	Participants (Count of Participants)
Thiamine	25
Placebo	30

KIM-1, NGAL, Cystatin-C at 24-hours after enrollment (NCT03550794)
Timeframe: 24 hours after enrollment

Change in Sequential Organ Failure Assessment (SOFA) Score

Intervention	pg/mL (Median)
	KIM-1	NGAL	Cystatin
Placebo	793.9	1558285.0	2183175.4
Thiamine	763.1	1067898.2	1689158.2

Defined as the day 4 post-randomization SOFA score minus the initial SOFA score. The Sequential Organ Failure Assessment (SOFA) Score is a mortality prediction score that is based on the degree of dysfunction of six organ systems. The score is calculated on admission and every 24 hours until discharge using the worst parameters measured during the prior 24 hours SOFA score ranges from 0 (no organ dysfunction) to 24 (highest possible score / organ dysfunction). (NCT03422159)
Timeframe: 4 days post-randomization

Hospital Length of Stay

Intervention	score on a scale (Mean)
Treatment Arm	2.9
Placebo Arm	1.93

Time from admitting to discharge of hospital stay. (NCT03422159)
Timeframe: From admission to the hospital until final discharge, up to 28 days.

Hospital Mortality

Intervention	Days (Mean)
Treatment Arm	11.5
Placebo Arm	11

In-hospital mortality rate. (NCT03422159)
Timeframe: Survival until hospital discharge, up to 28 days.

ICU Length of Stay

Intervention	Participants (Count of Participants)
Treatment Arm	11
Placebo Arm	13

Time from admitting to ICU to discharge. (NCT03422159)
Timeframe: From admission to the ICU until final discharge from the ICU, up to an average of 7 days.

ICU Mortality

Intervention	days (Mean)
Treatment Arm	4.76
Placebo Arm	4.66

ICU mortality rate (NCT03422159)
Timeframe: From admission to hospital until final discharge from the ICU, up to 28 days.

Procalcitonin (PCT) Clearance

Intervention	Participants (Count of Participants)
Treatment Arm	6
Placebo Arm	10

PCT at 96 hours minus initial PCT, divided by the initial PCT multiplied by 100. (NCT03422159)
Timeframe: 4 days post-randomization

Time to Vasopressor Independence (Hours)

Intervention	Percent (Mean)
Treatment Arm	63
Placebo Arm	58

Defined as the time from starting the active treatment/placebo to discontinuation of all pressors. (NCT03422159)
Timeframe: From start of vasopressor medication to final discontinuation of vasopressor medication, up to 7 days.

Ventilator Free Days

Intervention	hours (Mean)
HAT Treatment	27
Comparator	53

Number of days alive and off of the ventilator at day 28. (NCT03422159)
Timeframe: 28 Days post-randomization

30-day Mortality

Intervention	Days (Mean)
Treatment Arm	22
Placebo Arm	22.4

Mortality rate (NCT03389555)
Timeframe: Enrollment until 30-days after enrollment

Hospital Disposition: Survivors Discharged Home

Intervention	Participants (Count of Participants)
Vitamin C, Vitamin B1, Corticosteroids	35
Placebo	29

Home hospital disposition in patients who survive to discharge (NCT03389555)
Timeframe: Enrollment until hospital discharge, death, or 30-days, whichever comes first.

Hospital Mortality

Intervention	Participants (Count of Participants)
Vitamin C, Vitamin B1, Corticosteroids	34
Placebo	35

Hospital mortality rate (NCT03389555)
Timeframe: Enrollment until hospital discharge, death, or 30-days. Whichever comes first.

ICU Free Days

Intervention	Participants (Count of Participants)
Vitamin C, Vitamin B1, Corticosteroids	28
Placebo	23

Number of days that the patient was not in the ICU. Timeframe listed below. (NCT03389555)
Timeframe: From enrollment until 28 days after enrollment

Intensive Care Unit (ICU) Mortality

Intervention	Days (Median)
Vitamin C, Vitamin B1, Corticosteroids	22
Placebo	21

ICU mortality rate (NCT03389555)
Timeframe: Enrollment until ICU discharge, death, or 30-days. Whichever comes first.

Number of Participants With Delirium

Intervention	Participants (Count of Participants)
Vitamin C, Vitamin B1, Corticosteroids	23
Placebo	20

"Describes if patient has delirium as defined by the Confusion Assessment Method (CAM)-ICU. The CAM-ICU method requires that the patient have 3 features to qualify for delirium:~Acute Onset of Changes or Fluctuations in the Course of Mental Status (AND )~Inattention (AND)~Disorganized thinking (OR) Altered Level of Consciousness" (NCT03389555)
Timeframe: On day 3 (at approximately 72 hours) after the first study drug dose

Renal Failure

Intervention	Participants (Count of Participants)
Vitamin C, Vitamin B1, Corticosteroids	31
Placebo	35

"Development of renal failure as defined by a Kidney Disease Improving Global Outcomes [KDIGO] stage 3 or higher. There are 3 stages in the KDIGO scale with stage 3 being the worst (corresponds to renal failure).~Stage 1- serum creatinine 1.5 to 1.9 times baseline OR an increase in serum creatinine ≥ 0.3 mg/dL OR urine output < 0.5ml/kg/hour for 6-12 hours. Stage 2- serum creatinine 2.0-2.9 times baseline OR urine output <0.5mg/kg/hour for ≥ 12 hours Stage 3- serum creatinine 3.0 times baseline (or serum creatinine of more than or equal to 4.0 mg/dl with an acute increase of at least 0.5 mg/dl) (OR) Urine output less than 0.3 ml/kg/hour for 24 hours or anuria for 12 hours or new renal replacement therapy" (NCT03389555)
Timeframe: Enrollment until 7-days or discharge from the ICU

Shock Free Days

Intervention	Participants (Count of Participants)
Vitamin C, Vitamin B1, Corticosteroids	32
Placebo	27

Days not receiving vasopressor (NCT03389555)
Timeframe: Vasopressor free days over the first 7-days after enrollment

Ventilator Free Days

Intervention	Days (Median)
Vitamin C, Vitamin B1, Corticosteroids	5
Placebo	4

Days not receiving invasive mechanical ventilation (NCT03389555)
Timeframe: Ventilator free days over the first 7-days after enrollment

Sequential Organ Failure Assessment (SOFA) Score at Baseline and 72 Hours

Intervention	Days (Median)
Vitamin C, Vitamin B1, Corticosteroids	6
Placebo	6

Sequential Organ Failure Assessment (SOFA) Score at Baseline and 72 Hours. The SOFA score ranges from a minimum of 0 to a maximum of 24, with higher scores meaning worse outcomes. (NCT03389555)
Timeframe: Enrollment to 72-hours

Lactate Clearance

Intervention	Units on a scale (Mean)
	Enrollment SOFA score	72 hour SOFA score
Placebo	9.2	5.1
Vitamin C, Vitamin B1, Corticosteroids	9.1	4.4

The median lactate clearance from time zero to within 6 hours of the ED stay. (NCT01128413)
Timeframe: The median lactate clearance within 6 hours of the ED stay.

Hemodynamics as Characterized by Mean Arterial Pressure

Intervention	percent lactate clearance (Median)
Fluid Optimization (FO)	54
Routine Care (RC)	56

Organ perfusion pressure measured as Mean Arterial Pressure (MAP). It will be measured hourly for 24 postoperative hours for all subjects and compared between the two study groups over the whole time of observation as the main between-group effect in panel regression. (NCT03088345)
Timeframe: 24 hours post-operative

Hemodynamics as Characterized by Transpulmonary Pressure Gradient

Intervention	mmHg (Mean)
Vasopressin, Arginine	67
Placebo	66

The transpulmonary pressure gradient (TPG), defined as the difference between mean pulmonary arterial pressure (Ppa) and left/common atrial (common atrial) pressure (Pla) will be measured hourly for 24 postoperative hours for all subjects and compared between the two study groups over the whole time of observation as the main between-group effect in panel regression. (NCT03088345)
Timeframe: 24 hours post-operative

Hemodynamics as Characterized by Vasoactive Inotrope Score (VIS)

Intervention	mmHg (Mean)
Vasopressin, Arginine	6.4
Placebo	8.3

The vasoactive inotrope score (VIS) is a linear sum of vasoactive and inotrope durg infusion doses. It is usually reported as dimensionless but is sometimes reported as normalized to dopamine mcg/kg/min equivalents. The score starts at 0 and has no defined upper limit, with a commonly observed range 0-50. It is used as a measure of the intensity of hemodynamic support, with higher scores indicating more vasoactive drug support for patients. The relationship of VIS to other patient outcomes is not consistent. It will be calculated hourly for all subjects and compared between groups over the entire observation timeframe. (NCT03088345)
Timeframe: 48 hours post-operative

Liver Dysfunction as Characterized by Transaminase Levels

Intervention	units (Mean)
Vasopressin, Arginine	11
Placebo	11.3

Transaminase levels (alanine and aspartate, measured in IU/L ) will be tracked for all patients and changes will be compared between study groups. (NCT03088345)
Timeframe: 48 hours post-operative

Renal Dysfunction as Characterized by Change in Cystatin Level

Intervention	iU/L (Mean)
Vasopressin, Arginine	715
Placebo	522

Cystatin levels will be measured at baseline (immediately before cardiopulmonary bypass) 24 hours postoperative. The change (postoperative minus baseline) in cystatin level will be compared between groups. (NCT03088345)
Timeframe: from baseline pre-cardiopulmonary bypass to 24 hours post-operative

Resource Utilization Measured by Length of Stay (LOS)

Intervention	mg/L (Mean)
Vasopressin, Arginine	0.095
Placebo	0.017

Length of stay (LOS) measured in postoperative hours compared between groups (NCT03088345)
Timeframe: from time of operation until hospital discharge

Article	Year
What Is the Utility of Measuring Lactate Levels in Patients with Sepsis and Septic Shock? Seminars in respiratory and critical care medicine, 2021, Volume: 42, Issue:5 Topics: Humans; Hyperlactatemia; Lactic Acid; Resuscitation; Sepsis; Shock, Septic	2021
Using the lactate-to-albumin ratio to predict mortality in patients with sepsis or septic shock: a systematic review and meta-analysis. European review for medical and pharmacological sciences, 2022, Volume: 26, Issue:5 Topics: Albumins; Humans; Lactic Acid; ROC Curve; Sepsis; Shock, Septic	2022
Sepsis Management for the Nephrologist. Clinical journal of the American Society of Nephrology : CJASN, 2022, Volume: 17, Issue:6 Topics: Fluid Therapy; Humans; Lactic Acid; Nephrologists; Sepsis; Shock, Septic; Vasoconstrictor Agents	2022
Impact of supplemental thiamin on lactate levels in adults with septic shock. Nutrition in clinical practice : official publication of the American Society for Parenteral and Enteral Nutrition, 2023, Volume: 38, Issue:3 Topics: Ascorbic Acid; Humans; Hydrocortisone; Lactic Acid; Observational Studies as Topic; Retrospective St	2023
Effect of shenfu injection in patients with septic shock: A systemic review and meta-analysis for randomized clinical trials. Journal of ethnopharmacology, 2024, Feb-10, Volume: 320 Topics: Drugs, Chinese Herbal; Humans; Lactic Acid; Prognosis; Randomized Controlled Trials as Topic; Shock,	2024
Lactate: Where Are We Now? Critical care clinics, 2020, Volume: 36, Issue:1 Topics: Biomarkers; Early Goal-Directed Therapy; Female; Humans; Lactic Acid; Male; Practice Guidelines as T	2020
Early lactate area scores and serial blood lactate levels as prognostic markers for patients with septic shock: a systematic review. Infectious diseases (London, England), 2020, Volume: 52, Issue:7 Topics: Humans; Lactic Acid; Prognosis; Prospective Studies; Retrospective Studies; Shock, Septic	2020
Quantitative Assessment of Blood Lactate in Shock: Measure of Hypoxia or Beneficial Energy Source. BioMed research international, 2020, Volume: 2020 Topics: Animals; Critical Illness; Disease Models, Animal; Dogs; Humans; Hypoxia; Lactic Acid; Liver; Models	2020
Macrocirculatory and Microcirculatory Endpoints in Sepsis Resuscitation. Journal of intensive care medicine, 2021, Volume: 36, Issue:12 Topics: Hemodynamics; Humans; Lactic Acid; Microcirculation; Resuscitation; Sepsis; Shock, Septic	2021
Sepsis and Septic Shock Strategies. The Surgical clinics of North America, 2017, Volume: 97, Issue:6 Topics: Anti-Bacterial Agents; Arterial Pressure; Cardiomyopathies; Central Venous Pressure; Critical Care;	2017
[Lactic acidosis - update 2018]. Deutsche medizinische Wochenschrift (1946), 2018, Volume: 143, Issue:15 Topics: Acidosis, Lactic; Critical Care; Humans; Lactic Acid; Liver Diseases; Metabolic Clearance Rate; Prog	2018
Early goal-directed and lactate-guided therapy in adult patients with severe sepsis and septic shock: a meta-analysis of randomized controlled trials. Journal of translational medicine, 2018, 11-29, Volume: 16, Issue:1 Topics: Adult; Goals; Humans; Lactic Acid; Publication Bias; Randomized Controlled Trials as Topic; Risk Fac	2018
Efficacy and safety of Shenfu injection for septic shock: A systematic review and meta-analysis of randomized controlled trials. The American journal of emergency medicine, 2019, Volume: 37, Issue:12 Topics: Arterial Pressure; Drugs, Chinese Herbal; Heart Rate; Humans; Injections; Lactic Acid; Randomized Co	2019
Early recognition of septic shock in children. Klinische Padiatrie, 2013, Volume: 225, Issue:4 Topics: Biomarkers; Cell Hypoxia; Child; Clinical Laboratory Techniques; Early Diagnosis; Hemodynamics; Huma	2013
Lactate or ScvO2 as an endpoint in resuscitation of shock states? Minerva anestesiologica, 2013, Volume: 79, Issue:9 Topics: Endpoint Determination; Humans; Hypoxia; Lactic Acid; Oxygen; Prognosis; Resuscitation; Shock; Shock	2013
Oxygen extraction and perfusion markers in severe sepsis and septic shock: diagnostic, therapeutic and outcome implications. Current opinion in critical care, 2015, Volume: 21, Issue:5 Topics: Biomarkers; Blood Gas Analysis; Critical Care; Humans; Lactic Acid; Oxygen; Oxygen Consumption; Perf	2015
Tissue Oxygenation Monitoring as a Guide for Trauma Resuscitation. Critical care nurse, 2016, Volume: 36, Issue:3 Topics: Biomarkers; Female; Humans; Injury Severity Score; Lactic Acid; Male; Monitoring, Physiologic; Oxime	2016
The role of central venous oxygen saturation, blood lactate, and central venous-to-arterial carbon dioxide partial pressure difference as a goal and prognosis of sepsis treatment. Journal of critical care, 2016, Volume: 36 Topics: Carbon Dioxide; Humans; Lactic Acid; Oxygen; Partial Pressure; Patient Care Planning; Prognosis; Pro	2016
[Updated definition of sepsis : Implications for diagnostics and therapy principles]. Der Chirurg; Zeitschrift fur alle Gebiete der operativen Medizen, 2017, Volume: 88, Issue:1 Topics: Diagnosis, Differential; Fluid Therapy; Guideline Adherence; Humans; Hypotension; Lactic Acid; Sepsi	2017
Management of sepsis: early resuscitation. Clinics in chest medicine, 2008, Volume: 29, Issue:4 Topics: Calcitonin; Critical Care; Hemodynamics; Humans; Lactic Acid; Multiple Organ Failure; Natriuretic Pe	2008
Sepsis-induced tissue hypoperfusion. Critical care clinics, 2009, Volume: 25, Issue:4 Topics: Hemodynamics; Humans; Lactic Acid; Microcirculation; Oxygen; Resuscitation; Sepsis; Shock, Septic; S	2009
The role of serum lactate in the acute care setting. Journal of intensive care medicine, 2010, Volume: 25, Issue:5 Topics: Acidosis, Lactic; Adult; Aged; Antiretroviral Therapy, Highly Active; Biomarkers; Critical Care; Dru	2010
[Volume replacement in intensive care medicine]. Der Anaesthesist, 2011, Volume: 60, Issue:5 Topics: Blood Pressure; Blood Volume; Cardiomyopathy, Dilated; Cholecystectomy; Colloids; Critical Care; Goa	2011
Early interventions in severe sepsis and septic shock: a review of the evidence one decade later. Minerva anestesiologica, 2012, Volume: 78, Issue:6 Topics: Algorithms; Early Medical Intervention; Humans; Lactic Acid; Resuscitation; Sepsis; Shock, Septic; T	2012
Emergency management of severe sepsis and septic shock. Current opinion in critical care, 2012, Volume: 18, Issue:4 Topics: Albumins; Emergency Medical Services; Hemodynamics; Humans; Lactic Acid; Oxygen Consumption; Perfusi	2012
Gastrointestinal perfusion in septic shock. Anaesthesia and intensive care, 2007, Volume: 35, Issue:5 Topics: Animals; Biomarkers; Critical Care; Gastrointestinal Diseases; Humans; Lactic Acid; Laser-Doppler Fl	2007
Oxygen consumption during septic shock. Effects of inotropic drugs. Archives internationales de physiologie et de biochimie, 1984, Volume: 92, Issue:4 Topics: Blood Pressure; Cardiotonic Agents; Coronary Circulation; Dobutamine; Hemodynamics; Humans; Lactates	1984
Mechanisms and management of septic shock. Critical care clinics, 1993, Volume: 9, Issue:2 Topics: Anti-Bacterial Agents; Critical Care; Energy Metabolism; Hemodynamics; Humans; Immunologic Factors;	1993
[Is infection and septic shock caused by a global oxygen deficiency? An overview in 2 parts. 1: Infection and correlation between DO2 and VO2]. Anasthesiologie, Intensivmedizin, Notfallmedizin, Schmerztherapie : AINS, 1996, Volume: 31, Issue:3 Topics: Acid-Base Equilibrium; Cardiac Output; Humans; Hypoxia; Lactates; Lactic Acid; Oxygen; Oxygen Consum	1996
[Is sepsis and septic shock due to a global oxygen insufficiency? A review in 2 parts. 2: Sepsis and lactate]. Anasthesiologie, Intensivmedizin, Notfallmedizin, Schmerztherapie : AINS, 1996, Volume: 31, Issue:4 Topics: Acid-Base Equilibrium; Acidosis, Lactic; Humans; Lactates; Lactic Acid; Oxygen; Risk Factors; Shock,	1996
Definition and pathogenesis of septic shock. Current topics in microbiology and immunology, 1996, Volume: 216 Topics: Animals; Hemodynamics; Humans; Lactates; Lactic Acid; Prognosis; Shock, Septic	1996

lactic acid and Shock, Septic

Research Excerpts

Research

Studies (508)

Authors

Clinical Trials (65)

Trial Overview

Trial Outcomes

Change in Lactate Level

Change in the Sequential Organ Failure Assessment Score

ICU Free Days

In-hospital Mortality

Kidney Injury Biomarker

Number of Participants Experiences Acute Renal Failure

Number of Participants Receiving Renal Replacement Therapy

Number of Participants With Delirium on Day 3

Novel Biomarkers of Renal Injury

Change in Sequential Organ Failure Assessment (SOFA) Score

Hospital Length of Stay

Hospital Mortality

ICU Length of Stay

ICU Mortality

Procalcitonin (PCT) Clearance

Time to Vasopressor Independence (Hours)

Ventilator Free Days

30-day Mortality

Hospital Disposition: Survivors Discharged Home

Hospital Mortality

ICU Free Days

Intensive Care Unit (ICU) Mortality

Number of Participants With Delirium

Renal Failure

Shock Free Days

Ventilator Free Days

Sequential Organ Failure Assessment (SOFA) Score at Baseline and 72 Hours

Lactate Clearance

Hemodynamics as Characterized by Mean Arterial Pressure

Hemodynamics as Characterized by Transpulmonary Pressure Gradient

Hemodynamics as Characterized by Vasoactive Inotrope Score (VIS)

Liver Dysfunction as Characterized by Transaminase Levels

Renal Dysfunction as Characterized by Change in Cystatin Level

Resource Utilization Measured by Length of Stay (LOS)

Reviews

Trials

Other Studies