Prognostic value of blood lactate level on severe pneumonia patients with ARDS complicated with septic shock

ObjectiveTo investigate the predictive value of blood lactate level on the prognosis of severe pneumonitis patients with acute respiratory distress syndrome(ARDS) complicated with septic shock at admission, and provide evidence for the clinical prediction of patient's mortality.

MethodsA total of 102 severe pneumonia patients with ARDS complicated with septic shock were selected, and the clinical and biochemical data of patients were collected.The patients were divided into the death group and survival group according to the survival condition after 28 days of admission.The correlation between blood lactate level and mortality was observed, and the predictive value of 28-day mortality was analyzed.

ResultsThere were 40 deaths(39.2%).The SOFA score and APACHE Ⅱ score in death group were higher than those in survival group(P < 0.05), the hospital stay in death group was longer than that in survival group(P < 0.01), and the blood lactate level in death group was higher than that in survival group(P < 0.01).The differences of the levels of pH, BE, bicarbonate, PCO₂ and PO₂ between two groups were not statistically different(P>0.05).The results of ROC analysis showed that the area under the curve of lactate predicting 28-day mortality was 0.77, and the specificity and sensitivity were 64.2% and 79.9%, respectively.The results of multivariate analysis showed that the lactateOR(95% CI):3.458(1.441-10.027) and SOFA scoreOR(95% CI):1.524(1.276-5.034) were the independent risk factors of 28-day mortality of patients(P < 0.01 and P < 0.05).

ConclusionsThe severe pneumonia patients with ARDS complicated with septic shock with increasing arterial blood lactate level have a poor prognosis, and the arterial blood lactate level can be used to predict 28-day mortality.