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Mildly elevated lactate levels are associated with microcirculatory flow abnormalities and increased mortality: a microSOAP post hoc analysis

Overview of attention for article published in Critical Care, October 2017
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About this Attention Score

  • In the top 5% of all research outputs scored by Altmetric
  • High Attention Score compared to outputs of the same age (92nd percentile)
  • Good Attention Score compared to outputs of the same age and source (73rd percentile)

Mentioned by

news
1 news outlet
twitter
42 tweeters

Citations

dimensions_citation
28 Dimensions

Readers on

mendeley
100 Mendeley
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Title
Mildly elevated lactate levels are associated with microcirculatory flow abnormalities and increased mortality: a microSOAP post hoc analysis
Published in
Critical Care, October 2017
DOI 10.1186/s13054-017-1842-7
Pubmed ID
Authors

Namkje A. R. Vellinga, E. Christiaan Boerma, Matty Koopmans, Abele Donati, Arnaldo Dubin, Nathan I. Shapiro, Rupert M. Pearse, Peter H. J. van der Voort, Arjen M. Dondorp, Tony Bafi, Michael Fries, Tulin Akarsu-Ayazoglu, Andrius Pranskunas, Steven Hollenberg, Gianmarco Balestra, Mat van Iterson, Farid Sadaka, Gary Minto, Ulku Aypar, F. Javier Hurtado, Giampaolo Martinelli, Didier Payen, Frank van Haren, Anthony Holley, Hernando Gomez, Ravindra L. Mehta, Alejandro H. Rodriguez, Carolina Ruiz, Héctor S. Canales, Jacques Duranteau, Peter E. Spronk, Shaman Jhanji, Sheena Hubble, Marialuisa Chierego, Christian Jung, Daniel Martin, Carlo Sorbara, Jan Bakker, Can Ince

Abstract

Mildly elevated lactate levels (i.e., 1-2 mmol/L) are increasingly recognized as a prognostic finding in critically ill patients. One of several possible underlying mechanisms, microcirculatory dysfunction, can be assessed at the bedside using sublingual direct in vivo microscopy. We aimed to evaluate the association between relative hyperlactatemia, microcirculatory flow, and outcome. This study was a predefined subanalysis of a multicenter international point prevalence study on microcirculatory flow abnormalities, the Microcirculatory Shock Occurrence in Acutely ill Patients (microSOAP). Microcirculatory flow abnormalities were assessed with sidestream dark-field imaging. Abnormal microcirculatory flow was defined as a microvascular flow index (MFI) < 2.6. MFI is a semiquantitative score ranging from 0 (no flow) to 3 (continuous flow). Associations between microcirculatory flow abnormalities, single-spot lactate measurements, and outcome were analyzed. In 338 of 501 patients, lactate levels were available. For this substudy, all 257 patients with lactate levels ≤ 2 mmol/L (median [IQR] 1.04 [0.80-1.40] mmol/L) were included. Crude ICU mortality increased with each lactate quartile. In a multivariable analysis, a lactate level > 1.5 mmol/L was independently associated with a MFI < 2.6 (OR 2.5, 95% CI 1.1-5.7, P = 0.027). In a heterogeneous ICU population, a single-spot mildly elevated lactate level (even within the reference range) was independently associated with increased mortality and microvascular flow abnormalities. In vivo microscopy of the microcirculation may be helpful in discriminating between flow- and non-flow-related causes of mildly elevated lactate levels. ClinicalTrials.gov, NCT01179243 . Registered on August 3, 2010.

Twitter Demographics

The data shown below were collected from the profiles of 42 tweeters who shared this research output. Click here to find out more about how the information was compiled.

Mendeley readers

The data shown below were compiled from readership statistics for 100 Mendeley readers of this research output. Click here to see the associated Mendeley record.

Geographical breakdown

Country Count As %
Unknown 100 100%

Demographic breakdown

Readers by professional status Count As %
Researcher 13 13%
Other 9 9%
Student > Bachelor 8 8%
Student > Ph. D. Student 7 7%
Student > Doctoral Student 7 7%
Other 28 28%
Unknown 28 28%
Readers by discipline Count As %
Medicine and Dentistry 45 45%
Nursing and Health Professions 9 9%
Business, Management and Accounting 3 3%
Engineering 2 2%
Unspecified 1 1%
Other 7 7%
Unknown 33 33%

Attention Score in Context

This research output has an Altmetric Attention Score of 34. This is our high-level measure of the quality and quantity of online attention that it has received. This Attention Score, as well as the ranking and number of research outputs shown below, was calculated when the research output was last mentioned on 27 April 2019.
All research outputs
#1,036,588
of 23,508,125 outputs
Outputs from Critical Care
#879
of 6,178 outputs
Outputs of similar age
#22,969
of 328,186 outputs
Outputs of similar age from Critical Care
#18
of 63 outputs
Altmetric has tracked 23,508,125 research outputs across all sources so far. Compared to these this one has done particularly well and is in the 95th percentile: it's in the top 5% of all research outputs ever tracked by Altmetric.
So far Altmetric has tracked 6,178 research outputs from this source. They typically receive a lot more attention than average, with a mean Attention Score of 20.0. This one has done well, scoring higher than 85% of its peers.
Older research outputs will score higher simply because they've had more time to accumulate mentions. To account for age we can compare this Altmetric Attention Score to the 328,186 tracked outputs that were published within six weeks on either side of this one in any source. This one has done particularly well, scoring higher than 92% of its contemporaries.
We're also able to compare this research output to 63 others from the same source and published within six weeks on either side of this one. This one has gotten more attention than average, scoring higher than 73% of its contemporaries.