Early lactate clearance-guided therapy is more effective than ScvO2-oriented therapy in Sepsis
This study, carried out by Pan et al. and published in January 2019 by Medicine, involves a meta-analysis of different articles published between 1976 and February 2018, which aims to evaluate the effect of early therapy guided by lactate clearance as a potentially more effective resuscitation objective.
Recent studies suggest that lactate normalisation during resuscitation is a more powerful indicator of resuscitative adequacy than therapy guided by continuous central venous oxygen saturation (ScvO2).
The authors studied a total of 108 articles that fulfilled the inclusion requirements, of which 7 randomized controlled studies were finally reviewed.
Compared with therapy guided by continuous central venous oxygen saturation (ScvO2), early therapy aimed at lactate clearance was associated with a decreasedn in-hospital mortality, a shorter stay in the ICU, a shorter mechanical ventilation time and lower APACHE-II scores.
After analysing the results of this study, Pan et al. concluded that as a specific indicator of the resuscitation result, lactate clearance is superior to ScvO2 during a standard resuscitation paradigm.
More information available here