Doğan Serhat, Aslan Sefer, Börta Tayfun, Sarıaydın Mehmet, Sayıner Hakan Sezgin
Private Kayseri Acıbadem Hospital, General Surgery, Kayseri 38140, Turkey.
Giresun University Medicine School, Internal Medicine, Giresun 28200, Turkey.
Life (Basel). 2025 Feb 26;15(3):373. doi: 10.3390/life15030373.
In intensive care units (ICUs), serum lactate and methemoglobin (metHb) levels are considered significant biomarkers for predicting mortality in critically ill patients. This study investigates the relationship between lactate and metHb levels in blood gas analyses at admission and 24 h later, as well as their association with mortality in ICU patients. The study was conducted retrospectively between March and December 2022 at Adıyaman Training and Research Hospital, evaluating 114 patients, with statistical analyses performed on the collected data. The results indicated a statistically significant decrease in lactate levels between admission and 24 h after ( = 0.004). However, no significant change was found in metHb levels ( > 0.05). Lactate clearance was significantly lower in deceased patients compared to survivors ( = 0.037), whereas metHb clearance showed no statistically significant association with mortality. Lactate is highlighted as a key indicator of tissue hypoxia and plays a critical role in managing critically ill patients. Elevated lactate levels are associated with impaired oxygenation and worse prognoses. The literature consistently supports the association between high lactate levels and increased mortality in conditions such as sepsis and hemorrhagic shock. Similarly, this study confirms the prognostic value of lactate, particularly in the early phases of ICU admission. In contrast, metHb levels were not found to significantly impact mortality. Although some studies suggest a potential role of metHb as a biomarker for oxidative stress in inflammatory diseases, this relationship was not supported by the current findings. In conclusion, serum lactate levels serve as a crucial tool for mortality prediction and patient management in ICUs, while metHb levels have limited prognostic value. These findings suggest that greater emphasis should be placed on lactate monitoring in the management of critically ill patients.
在重症监护病房（ICU）中，血清乳酸盐和高铁血红蛋白（metHb）水平被视为预测危重症患者死亡率的重要生物标志物。本研究调查了入院时和24小时后血气分析中乳酸盐与metHb水平之间的关系，以及它们与ICU患者死亡率的关联。该研究于2022年3月至12月在阿迪亚曼培训与研究医院进行回顾性研究，评估了114例患者，并对收集的数据进行了统计分析。结果表明，入院时与入院后24小时之间乳酸盐水平有统计学意义的下降（P = 0.004）。然而，metHb水平未发现有显著变化（P > 0.05）。与存活患者相比，死亡患者的乳酸盐清除率显著更低（P = 0.037），而metHb清除率与死亡率未显示出统计学意义的关联。乳酸盐被视为组织缺氧的关键指标，在危重症患者的管理中起着关键作用。乳酸盐水平升高与氧合受损和预后较差相关。文献一致支持高乳酸盐水平与脓毒症和失血性休克等病症中死亡率增加之间的关联。同样，本研究证实了乳酸盐的预后价值，尤其是在ICU入院的早期阶段。相比之下，未发现metHb水平对死亡率有显著影响。尽管一些研究表明metHb作为炎症性疾病氧化应激生物标志物的潜在作用，但当前研究结果不支持这种关系。总之，血清乳酸盐水平是ICU中死亡率预测和患者管理的关键工具，而metHb水平的预后价值有限。这些发现表明，在危重症患者的管理中应更加强调乳酸盐监测。
