Abstract:
BACKGROUND:Lactate is a robust prognostic marker for the outcome of critically ill patients. Several small studies reported that metformin users have higher lactate levels at ICU admission without a concomitant increase in mortality. However, this has not been investigated in a larger cohort. We aimed to determine whether the association between lactate levels around ICU admission and mortality is different in metformin users compared to metformin nonusers. METHODS:This cohort study included patients admitted to ICUs in northern Denmark between January 2010 and August 2017 with any circulating lactate measured around ICU admission, which was defined as 12 h before until 6 h after admission. The association between the mean of the lactate levels measured during this period and 30-day mortality was determined for metformin users and nonusers by modelling restricted cubic splines obtained from a Cox regression model. RESULTS:Of 37,293 included patients, 3183 (9%) used metformin. The median (interquartile range) lactate level was 1.8 (1.2-3.2) in metformin users and 1.6 (1.0-2.7) mmol/L in metformin nonusers. Lactate levels were strongly associated with mortality for both metformin users and nonusers. However, the association of lactate with mortality was different for metformin users, with a lower mortality rate in metformin users than in nonusers when admitted with similar lactate levels. This was observed over the whole range of lactate levels, and consequently, the relation of lactate with mortality was shifted rightwards for metformin users. CONCLUSION:In this large observational cohort of critically ill patients, early lactate levels were strongly associated with mortality. Irrespective of the degree of hyperlactataemia, similar lactate levels were associated with a lower mortality rate in metformin users compared with metformin nonusers. Therefore, lactate levels around ICU admission should be interpreted according to metformin use.
journal_name
Ann Intensive Carejournal_title
Annals of intensive careauthors
Posma RA,Frøslev T,Jespersen B,van der Horst ICC,Touw DJ,Thomsen RW,Nijsten MW,Christiansen CFdoi
10.1186/s13613-020-00652-0subject
Has Abstractpub_date
2020-03-26 00:00:00pages
36issue
1issn
2110-5820pii
10.1186/s13613-020-00652-0journal_volume
10pub_type
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journal_title:Annals of intensive care
pub_type: 杂志文章
doi:10.1186/s13613-020-00798-x
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pub_type: 杂志文章
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更新日期:2016-12-01 00:00:00
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journal_title:Annals of intensive care
pub_type: 杂志文章
doi:10.1186/s13613-018-0404-8
更新日期:2018-05-02 00:00:00
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doi:10.1186/s13613-017-0350-x
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doi:10.1186/s13613-017-0309-y
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journal_title:Annals of intensive care
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journal_title:Annals of intensive care
pub_type: 杂志文章
doi:10.1186/s13613-017-0351-9
更新日期:2018-01-10 00:00:00
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journal_title:Annals of intensive care
pub_type: 杂志文章
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journal_title:Annals of intensive care
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pub_type: 杂志文章
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更新日期:2017-12-01 00:00:00
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journal_title:Annals of intensive care
pub_type: 杂志文章
doi:10.1186/s13613-020-00753-w
更新日期:2020-10-14 00:00:00
abstract:UNLABELLED: BACKGROUND:A history of prolonged and excessive consumption of alcohol increases the risk for infections. The goal of this study was to investigate circulating white blood cells (WBC) differentiated by flow cytometry and neutrophil CD64 expression in excessive alcohol drinkers versus abstinent or moderate ...
journal_title:Annals of intensive care
pub_type: 杂志文章
doi:10.1186/2110-5820-2-50
更新日期:2012-12-31 00:00:00
abstract:BACKGROUND:Intensivists' clinical decision making pursues two main goals for patients: to decrease mortality and to improve quality of life and functional status in survivors. Patient-important outcomes are gaining wide acceptance in most fields of clinical research. We sought to systematically review how well patient-...
journal_title:Annals of intensive care
pub_type: 杂志文章,评审
doi:10.1186/s13613-017-0243-z
更新日期:2017-12-01 00:00:00
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journal_title:Annals of intensive care
pub_type: 杂志文章
doi:10.1186/s13613-017-0343-9
更新日期:2017-12-19 00:00:00
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journal_title:Annals of intensive care
pub_type: 杂志文章
doi:10.1186/s13613-017-0298-x
更新日期:2017-12-01 00:00:00
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journal_title:Annals of intensive care
pub_type: 杂志文章
doi:10.1186/s13613-021-00801-z
更新日期:2021-01-27 00:00:00
abstract:: Multiple experimental and human trials have shown that microcirculatory alterations are frequent in sepsis. In this review, we discuss the characteristics of these alterations, the various mechanisms potentially involved, and the implications for therapy. Sepsis-induced microvascular alterations are characterized by ...
journal_title:Annals of intensive care
pub_type: 杂志文章
doi:10.1186/2110-5820-1-27
更新日期:2011-07-19 00:00:00
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journal_title:Annals of intensive care
pub_type: 已发布勘误
doi:10.1186/s13613-020-00691-7
更新日期:2020-06-02 00:00:00
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journal_title:Annals of intensive care
pub_type: 杂志文章
doi:10.1186/2110-5820-2-1
更新日期:2012-02-03 00:00:00
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journal_title:Annals of intensive care
pub_type: 杂志文章
doi:10.1186/s13613-020-00699-z
更新日期:2020-06-12 00:00:00
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journal_title:Annals of intensive care
pub_type: 杂志文章
doi:10.1186/s13613-016-0128-6
更新日期:2016-12-01 00:00:00
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journal_title:Annals of intensive care
pub_type: 杂志文章
doi:10.1186/2110-5820-3-4
更新日期:2013-02-15 00:00:00
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journal_title:Annals of intensive care
pub_type: 信件
doi:10.1186/s13613-020-00745-w
更新日期:2020-10-01 00:00:00
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journal_title:Annals of intensive care
pub_type: 杂志文章
doi:10.1186/2110-5820-2-13
更新日期:2012-05-30 00:00:00
abstract:BACKGROUND:Acute kidney injury (AKI) occurs in up to 50% of all critically ill patients and hemodynamic abnormalities are assumed to contribute, but their nature and share is still unclear. We explored the associations between hemodynamic variables, including cardiac index and right ventricular function, and the occurr...
journal_title:Annals of intensive care
pub_type: 杂志文章
doi:10.1186/s13613-019-0513-z
更新日期:2019-03-13 00:00:00
abstract:BACKGROUND:Many maneuvers assessing fluid responsiveness (minifluid challenge, lung recruitment maneuver, end-expiratory occlusion test, passive leg raising) are considered as positive when small variations in cardiac index, stroke volume index, stroke volume variation or pulse pressure variation occur. Pulse contour a...
journal_title:Annals of intensive care
pub_type: 杂志文章
doi:10.1186/s13613-019-0590-z
更新日期:2019-10-11 00:00:00
abstract::Pharmacological interventions are commonly considered in acute respiratory distress syndrome (ARDS) patients. Inhaled nitric oxide (iNO) and neuromuscular blockers (NMBs) are used in patients with severe hypoxemia. No outcome benefit has been observed with the systematic use of iNO. However, a sometimes important impr...
journal_title:Annals of intensive care
pub_type: 杂志文章
doi:10.1186/2110-5820-3-20
更新日期:2013-07-03 00:00:00
abstract::Anemia and red blood cell (RBC) transfusion occur frequently in hospitalized patients with cardiac disease. In this narrative review, we report the epidemiology of anemia and RBC transfusion in hospitalized adults and children (excluding premature neonates) with cardiac disease, and on the outcome of anemic and transf...
journal_title:Annals of intensive care
pub_type: 杂志文章,评审
doi:10.1186/2110-5820-4-16
更新日期:2014-06-02 00:00:00
abstract:BACKGROUND:The clinical interest of using bubble humidification of oxygen remains controversial. This study was designed to further explore whether delivering dry oxygen instead of bubble-moistened oxygen had an impact on discomfort of ICU patients. METHODS:This randomized multicenter non-inferiority open trial includ...
journal_title:Annals of intensive care
pub_type: 杂志文章
doi:10.1186/s13613-018-0472-9
更新日期:2018-12-17 00:00:00