Objective: To investigate the prognosis value of lactate and lactate clearance rate in patients during burn shock stage. Methods: 88 patients with blood lactate>2.0 mmol/L during burn shock in the hosptital burn unit were retrospectively analyzed. The patients were divided into survivor group (n=48) and death group (n=40) according to whether they survived on 28th day. Blood lactate levels were measured at admission (0 h) and at 6 h, 12 h, 24 h and 72h after admission. The partial pressure of blood oxygen was recorded, as well as the acute physiology and chronic health evaluation (APACHE Ⅱ). The correlation of the lactate blood level at 0 h, PO2 between APACHE Ⅱ scores, and the relationship between lactate clearance and prognosis was analyzed at each time point. Results: Blood lactate levels at 0 h, 6 h, 12 h, 24 h and 72 h in the death group were significantly higher than those in the surviving group, resoectively. Lactate levels of patients during burn shock on admission were significantly associated with APACHE II scores (P<0.01), but not with partial pressure of oxygen (P>0.05). Multivariate logistic regression analysis showed that the lactate clearance rate at 6 h and 12 h could be used as a prognostic factor to independently evaluate the prognosis. Conclusions: The dynamic monitoring of blood lactate is of great significance in patients with burn shock. Persistent hyperlactacidemia indicates a poor prognosis. The lactic acid clearance rate at 6 h and 12 h may be used as indices for prognostic evaluation.
 KOMPANJE E J,JANSEN T C,VAN DER HOVEN B,et al.The first demonstration of lactic acid in human blood in shock by Johann Joseph Scherer (1814-1869) in January 1843[J].Intensive Care Med,2007,33(11):1967-1971.
 NGUYEN H B,RIVERS E P,KNOBLICH B P,et al.Early lactate clearance is associated with improved outcome in severe sepsis and septic shock[J].Crit Care Med,2004,32(8):1637-1642.
 ARNOLD R C,SHAPIRO N I,JONES A E,et al.Multicenter study of early lactate clearance as a determinant of survival in patients with presumed sepsis[J].Shock,2009,32(1):35-39.
 RYOO S M,LEE J B,LEE Y S,et al.Lactate level versus lactate clearance for predicting mortality in patients with septic shock defined by sepsis-3[J].Crit Care Med,2018,46(6):e489-e495.
 KRAUT J A,MADIAS N E.Lactic acidosis[J].N Engl J Med,2014,371(24):2309-2319.
 GAIESKI D F,MIKKELSEN M E,BAND R A,et al.Impact of time to antibiotics on survival in patients with severe sepsis orseptic shock in whom early goal-directed therapy was initiatedin the emergency department[J].Crit Care Med,2010,38(4):1045-1053.
 BOULAIN T,GAROT D,VIGNON P,et al.Prevalence of low central venous oxygen saturation in the first hours of intensive care unit admission and associated mortality in septic shock patients:a prospective multicentre study[J].Crit Care,2014,18(6):609-616.
 LIU X Y,JI W L,WANG J F,et al.Application strategy of PiCCO in septic shock patients[J].Exp Ther Med,2016,11(4):1335-1339.
 JONES A E,SHAPIRO N I,TRZECIAK S,et al.Lactate clearancevs central venous oxygen saturation as goals of early sepsistherapy:a randomized clinical trial[J].JAMA,2010,303(8):739-746.
 JONES A E.Point:Should lactate clearance be substitutedfor central venous oxygen saturation as goals of early severe sepsis and septic shock therapy lactate clearance as a goal for septic shock[J].Chest,2011,140(6):1406-1408.
 JEPPESEN J B,MORTENSEN C,BENDTSEN F,et al.Lactate metabolism in chronic liver disease[J].Scand J Clin Lab Invest,2013,73(4):293-299.
 LEE Y K,HWANG S Y,SHIN T G,et al.Prognostic value of lactate and central venous oxygen saturation after early resuscitation in sepsis patients[J].PLoS One,2016,11(6):e0157225.
 ALAN E.JONES,M D.Lactate clearance for assessing response to resuscitation in severe sepsis[J].Acad Emerg Med,2013,20(8):844-847.
 LEE S M,KIM S E,KIM E B,et al.Lactate clearance and vasopressor seem to be predictors for mortality in severe sepsis patients with lactic acidosis supplementing sodium bicarbonate:A retrospective analysis[J].PLoS One,2015,10(12):e0145181.