AIMS
To understand if intravenous (IV) fluid through a ‘drip’ is an effective treatment for patients who have raised lactate level in hospital.
BACKGROUND
Lactate is a chemical produced by the body as cells consume energy. In times of stress more lactate is produced.
People suffering from certain severe illnesses may have a high lactate level in their blood. This is particularly common in the following:
- Severe infections which the body cannot properly control (sepsis)
- People who have sustained severe injuries (traumatic injury)
- People who are critically unwell with other illnesses (needing treatment in an intensive care unit)
Some patients will develop a high lactate level when they are in hospital. Doctors recognise that this indicates the patient is becoming more unwell, but it is often challenging to know exactly what is causing the lactate level to be raised.
Certain people with high lactate levels do not suffer poor health. For example marathon runners will have very raised lactate levels while running, as will patients who have recently had a seizure – both tolerate this well. Researchers don’t yet fully understand what lactate does, or why it indicates harm in only some situations.
Many doctors will try to treat raised lactate by prescribing their patient IV fluid. It is not clear whether this treatment works to lower lactate level, or if it improves patients’ long-term chance of recovery. But we do know that receiving too much IV fluid causes harm to patients.
RESEARCH
This study will look at patients in the intensive care unit who develop a high lactate value. It will assess how much, and what type of IV fluid they receive, and how long it takes for their lactate value to return to normal. It will also look at their outcomes – time spent on the intensive care unit and in hospital, and how likely they are to die.
PATIENT INVOLVEMENT
This project is affiliated with an ongoing laboratory-based study, which has been presented to and approved by the patient and public involvement group at the NIHR Surgical Reconstruction and Microbiology Research Centre. The group unanimously endorsed the study.
APPROVAL
This project was supported unanimously by the PIONEER Data Trust Committee.
This research is led by Dr Joseph Alderman, Critical Care, UHB
