Comparison of Lactate Clearance after Resuscitation with Lactated vs. Acetated Crystalloid in Septic Shock.

Background: Buffered crystalloid solutions are often recommended as the first choice for intravenous resuscitation. Sepsis-related morbidity and mortality are lower when patients with septic shock are resuscitated early. Purpose: To compare the efficacy and potency of lactate clearance, resolution of metabolic acidosis, improvement in hemodynamic status, and resolution of shock after resuscitation with lactate- and acetatebuffered solutions in septic shock. Methods: Of the 60 patients with septic shock and sepsis, 30 were recruited for lactate solution and 30 for acetate solution. After admission of these patients to the ICU, we perform ABG of the patient to determine baseline PH, PCO2, PO2, bicarbonate, and lactate. After 12 hours of resuscitation, we repeat the ABG to determine the improvement in sepsis/septic lactate clearance and resolution of metabolic acidosis in both groups. Results:The mean change in pH and pO2 was significantly increased and pCO2 significantly decreased in the acetate group from admission to 12 hours after admission, whereas only pO2 was significantly increased in the lactate group. Mean lactate values at admission and after 12 hours were 6.20±2.67 and 4.60±2.13, respectively, in the acetate group and 5.24±1.44 and 2.98±0.53, respectively, in the lactate group. Mean SBP (mmHg) and DBP (mmHg) were significantly increased, and HR (beats/min) and RR (/min) were significantly decreased from admission to 12 hours after admission in the acetate group and the lactate group. Conclusion: Mean lactate was significantly decreased more in the lactate group (2.26) than in the acetate group. In addition, SBP (mmHg) and DBP (mmHg) were increased more and HR (beats/min) decreased more in the acetate group than in the lactate group. [ABSTRACT FROM AUTHOR]