The Association of Elevated Lactate Level and Rate of Intensive Care Unit Admissions, Endoscopies, and Transfusion of Packed Cell in Patients with Acute Gastrointestinal Bleeding

Mohammad Salehi; Maryam Golmohamadi; Shahriar Nikpour; Latif Gachkar; Safura Al Sadat Hoseini

doi:10.18502/jimc.v5i4.11335

Mohammad Salehi Loghman Hakim Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran
Maryam Golmohamadi Faculty of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran
Shahriar Nikpour Loghman Hakim Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran
Latif Gachkar Infectious Diseases and Tropical Medicine Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
Safura Al Sadat Hoseini Faculty of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran

DOI: https://doi.org/10.18502/jimc.v5i4.11335

Keywords: Biomarkers, Gastrointestinal hemorrhage, Intensive care units, Lactates

Abstract

Background: Management of patients with Gastrointestinal Bleeding (GIB) based on chronicity and severity of it can vary from outpatient medical therapy to intensive caring in life-threatening cases. Initial clinical management decision in patients presenting to emergency department with acute GIB is often based on identifying high- and low-risk patients. Patients with high risks of adverse outcomes, such as death or re-bleeding, are more likely to benefit from early, aggressive management, whereas patients with lower risks may be considered for early hospital discharge or even outpatient management. Serum lactate level is generally an indicator of the overall adequacy of peripheral oxygenation. In severe cases of acute GIB, the hemodynamic of the patients disturbs. In this study, we are evaluating whether higher serum lactate level is potentially a biomarker for predicting the future need for special management considerations.

Methods: 168 patients with confirmed acute GIB have entered this study. The serum lactate level of participants was measured and documented as well as their demographic data and their medical history. The participants’ need for ICU admission, blood transfusion, emergent endoscopy, and mortality rate were documented and assessed prospectively.

Results: Patients with higher levels of serum lactate levels were more admitted to the intensive care unit in the upcoming days. Anticoagulant use and abdominal pain prevalence were also significantly different in the study groups (p>0.05). Other assessments were not statistically significant.

Conclusion: Higher levels of serum lactate predict a higher probability of ICU admission in patients with acute GIB.