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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
40 tweeters

Citations

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23 Dimensions

Readers on

mendeley
99 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 40 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 99 Mendeley readers of this research output. Click here to see the associated Mendeley record.

Geographical breakdown

Country Count As %
Unknown 99 100%

Demographic breakdown

Readers by professional status Count As %
Researcher 13 13%
Other 9 9%
Student > Doctoral Student 8 8%
Student > Bachelor 8 8%
Student > Ph. D. Student 7 7%
Other 29 29%
Unknown 25 25%
Readers by discipline Count As %
Medicine and Dentistry 47 47%
Nursing and Health Professions 8 8%
Business, Management and Accounting 3 3%
Engineering 2 2%
Unspecified 2 2%
Other 7 7%
Unknown 30 30%

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
#1,026,251
of 23,026,672 outputs
Outputs from Critical Care
#870
of 6,091 outputs
Outputs of similar age
#23,239
of 327,053 outputs
Outputs of similar age from Critical Care
#18
of 63 outputs
Altmetric has tracked 23,026,672 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 6,091 research outputs from this source. They typically receive a lot more attention than average, with a mean Attention Score of 19.4. 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 327,053 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.