Relative efficacy and safety of early lactate clearance-guided therapy resuscitation in patients with sepsis: A meta-analysis

Medicine
Jianzhen PanXiangmin Li

Abstract

Compelling evidence has shown that aggressive resuscitation bundles are one of the cornerstones of the successful treatment of patients with sepsis. Recent studies suggest that lactate normalization during resuscitation is a more powerful indicator of resuscitative adequacy; however, early lactate clearance-guided therapy is still not recommended. We performed this meta-analysis to evaluate the effect of early lactate clearance-directed therapy as a potentially more effective resuscitation target. Studies were identified using PubMed, Embase, and the Cochrane Library without region, publication type, or language restrictions. Randomized trials were included when they compared the efficacy and safety of lactate clearance-guided resuscitation versus central venous oxygen saturation (ScvO2)-guided therapy. The primary outcome was mortality, and the secondary outcomes were intensive care unit (ICU) stay, length of hospital stay, mechanical ventilation time, Acute Physiology and Chronic Health Evaluation-II (APACHE-II) score, and Sepsis-related Organ Failure Assessment (SOFA) score. Seven randomized controlled trials encompassing 1301 cases were reviewed. Compared with guided ScvO2 therapy, early lactate clearance-directed therapy w...Continue Reading

Associated Clinical Trials

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Citations

Apr 14, 2020·Journal of Intensive Care Medicine·Jacob C Jentzer, Steven M Hollenberg
Jun 15, 2019·Medizinische Klinik, Intensivmedizin und Notfallmedizin·D MomcicevicP Kovacevic
Apr 17, 2021·Journal of Comparative Effectiveness Research·Effat Davoudi-MonfaredHossein Khalili
Oct 25, 2020·The American Journal of Emergency Medicine·Romain JouffroyBenoit Vivien
Sep 1, 2019·Current Opinion in Biomedical Engineering·Gregory L DamhorstWilbur A Lam
Aug 4, 2021·Critical Care Nursing Clinics of North America·Nicole Kupchik
Sep 21, 2021·Seminars in Respiratory and Critical Care Medicine·Jeremy WeinbergerChanu Rhee
Jul 15, 2020·Kidney & Blood Pressure Research·Igor MatyukhinDaniel Patschan
Nov 12, 2021·The American Surgeon·Miguel BelaunzaranAdel Elkbuli
Dec 3, 2021·Clinical Chemistry and Laboratory Medicine : CCLM·Giovanni CarpenèGiuseppe Lippi

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