Emergency management and the relationship between serum lactate level in sepsis

Aim: In this study; we aimed to evaluate of the varying lactate levels in the process of changing metabolism due to sepsis and determine effectiveness on emergency diagnosis and treatment in patients admitted to the emergency department. Materials and Methods: This study was performed with 107 patients followed by sepsis between dates of 31.10.2014 - 16.02.2016. Age, sex, symptoms, vital and physical examination findings, SIRS criteria, general changes, inflammatory changes, hemodynamic changes and organ dysfunction changes, tissue perfusion changes, infection localization, treatment status, mortality rates were evaluated in terms of relations with lactate level. Data were analyzed using SPSS version of Windows 18. The distribution of variables was checked with the Kolmogorov-Smirnov test. In analyzing the data, Mann Whitney U, Kruskal Wallis and Pearson correlation tests were used. p<0,05 was considered statistically significant. Results: In our study, the median age of patients was 63 years, 60,7% were male. The most common physical finding detected in patients was fever. The most common infection focus was the respiratory system. The median lactate level of the patients was detected 2,4 mmol / L. Lactate levels had no relationship with comorbid diseases, the number of SIRS criteria, the focus of infection, positive culture, emergency follow-up period and duration of hospitalization (p> 0,05).Lactate levels were significantly higher in patients with lower mean arterial pressure and systolic blood pressure levels (p <0,05). Lactate levels were significantly higher in patients with bronchospasm, acute lung injury, ARDS, blood coagulation disorders, decreased capillary refill / spotting and unexplained metabolic acidosis (p <0,05). A negative correlation was observed between hypoglycemia and lactate levels (p <0,05). Increased lactate levels were detected when clinical of patients got worse (p <0,05). The mortality rate of the patients was 15%, lactate levels were significantly higher in patients with mortal prognosis (p <0,05). Conclusions: The height of the lactate level of patients with sepsis admitted to the emergency clinic is a sign of bad clinic and high mortality rate Key words: sepsis, lactate, emergency, mortality