2017
Evaluation of a novel 5-group classification system of sepsis by vasopressor use and initial serum lactate in the emergency department
Swenson KE, Dziura JD, Aydin A, Reynolds J, Wira CR. Evaluation of a novel 5-group classification system of sepsis by vasopressor use and initial serum lactate in the emergency department. Internal And Emergency Medicine 2017, 13: 257-268. PMID: 28132131, DOI: 10.1007/s11739-017-1607-y.Peer-Reviewed Original ResearchConceptsInitial serum lactate levelSerum lactate levelsEmergency departmentLactate elevationVasoplegic shockLactate levelsCryptic shockVasopressor useInfected patientsShock mortalityHigh-risk ED patientsGroup mortality rateInitial serum lactateVasopressor-dependent patientsIdentifiable risk factorsSepsis-3 definitionRisk-stratify patientsHigh-risk subgroupsInitial lactate levelProximal phaseVasopressor dependenceVasopressor requirementHospital outcomesED patientsSerum lactate
2015
Lactate Clearance Predicts Survival Among Patients in the Emergency Department with Severe Sepsis
Bhat SR, Swenson KE, Francis MW, Wira CR. Lactate Clearance Predicts Survival Among Patients in the Emergency Department with Severe Sepsis. Western Journal Of Emergency Medicine 2015, 16: 1118-1126. PMID: 26759665, PMCID: PMC4703153, DOI: 10.5811/westjem.2015.10.27577.Peer-Reviewed Original ResearchConceptsSevere sepsisSeptic shockLactate clearanceClearance groupLactate levelsPredictors of mortalityEmergency department patientsInitial lactate levelCross-sectional studySepsis registryVasopressor supportED stayDepartment patientsHospital interventionsMechanical ventilationEmergency departmentLactate changesSepsisPatientsMortality rateHigh mortalityHospital floorMortalityClearanceED
2007
Effective lactate clearance is associated with improved outcome in post-cardiac arrest patients
Donnino MW, Miller J, Goyal N, Loomba M, Sankey SS, Dolcourt B, Sherwin R, Otero R, Wira C. Effective lactate clearance is associated with improved outcome in post-cardiac arrest patients. Resuscitation 2007, 75: 229-234. PMID: 17583412, DOI: 10.1016/j.resuscitation.2007.03.021.Peer-Reviewed Original ResearchConceptsPost-cardiac arrest patientsHigher lactate clearanceArrest patientsLactate clearanceAPACHE II scoreCardiac arrest patientsInitial lactate levelUrban emergency departmentPre-hospital providersEmergency medical servicesHospital mortalityTraumatic arrestHospital courseHospital survivalII scorePrimary endpointHospital dischargeImproved mortalityOverall mortalityMean lactateMultivariable analysisSuccessful resuscitationCardiac arrestEmergency departmentMean age