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      Investigations into the Effects of pH on Quantitative Measurements of Lactate in Biological Media Using ATR-FTIR Spectroscopy

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          Abstract

          Quantification of lactate/lactic acid in critical care environments is essential as lactate serves as an important biochemical marker for the adequacy of the haemodynamic circulation in shock and of cell respiration at the onset of sepsis/septic shock. Hence, in this study, ATR-FTIR was explored as a potential tool for lactate measurement, as the current techniques depend on sample preparation and fails to provide rapid response. Moreover, the effects of pH on PBS samples (7.4, 7, 6.5 and 6) and change in solution conditions (PBS to whole blood) on spectral features were also investigated. A total 189 spectra from five sets of lactate containing media were obtained. Results suggests that lactate could be measured with more than 90% accuracy in the wavenumber range of 1500–600 cm − 1 . The findings of this study further suggest that there exist no effects of change in pH or media, when estimating lactate concentration changes in this range of the Mid-IR spectral region.

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          Surviving Sepsis Campaign: guidelines on the management of critically ill adults with Coronavirus Disease 2019 (COVID-19)

          Waleed Alhazzani, Morten Hylander Møller, Yaseen M. Arabi … (2020)
          Background The novel severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is the cause of a rapidly spreading illness, Coronavirus Disease 2019 (COVID-19), affecting thousands of people around the world. Urgent guidance for clinicians caring for the sickest of these patients is needed. Methods We formed a panel of 36 experts from 12 countries. All panel members completed the World Health Organization conflict of interest disclosure form. The panel proposed 53 questions that are relevant to the management of COVID-19 in the ICU. We searched the literature for direct and indirect evidence on the management of COVID-19 in critically ill patients in the ICU. We identified relevant and recent systematic reviews on most questions relating to supportive care. We assessed the certainty in the evidence using the Grading of Recommendations, Assessment, Development and Evaluation (GRADE) approach, then generated recommendations based on the balance between benefit and harm, resource and cost implications, equity, and feasibility. Recommendations were either strong or weak, or in the form of best practice recommendations. Results The Surviving Sepsis Campaign COVID-19 panel issued 54 statements, of which 4 are best practice statements, 9 are strong recommendations, and 35 are weak recommendations. No recommendation was provided for 6 questions. The topics were: (1) infection control, (2) laboratory diagnosis and specimens, (3) hemodynamic support, (4) ventilatory support, and (5) COVID-19 therapy. Conclusion The Surviving Sepsis Campaign COVID-19 panel issued several recommendations to help support healthcare workers caring for critically ill ICU patients with COVID-19. When available, we will provide new recommendations in further releases of these guidelines. Electronic supplementary material The online version of this article (10.1007/s00134-020-06022-5) contains supplementary material, which is available to authorized users.
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            The Surviving Sepsis Campaign Bundle

            Laura E Evans, Mitchell Levy, Andrew Rhodes (2018)
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              Lactic Acidosis in Sepsis: It's Not All Anaerobic: Implications for Diagnosis and Management.

              Bandarn Suetrong, Keith Walley (2016)
              Increased blood lactate concentration (hyperlactatemia) and lactic acidosis (hyperlactatemia and serum pH < 7.35) are common in patients with severe sepsis or septic shock and are associated with significant morbidity and mortality. In some patients, most of the lactate that is produced in shock states is due to inadequate oxygen delivery resulting in tissue hypoxia and causing anaerobic glycolysis. However, lactate formation during sepsis is not entirely related to tissue hypoxia or reversible by increasing oxygen delivery. In this review, we initially outline the metabolism of lactate and etiology of lactic acidosis; we then address the pathophysiology of lactic acidosis in sepsis. We discuss the clinical implications of serum lactate measurement in diagnosis, monitoring, and prognostication in acute and intensive care settings. Finally, we explore treatment of lactic acidosis and its impact on clinical outcome.
              Article 0 comments Cited 94 times – based on 0 reviews     Review now
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                Author and article information

                Contributors
                Derek J. McPhee: Role: Academic Editor
                Journal
                Journal ID (nlm-ta): Molecules
                Journal ID (iso-abbrev): Molecules
                Journal ID (publisher-id): molecules
                Title: Molecules
                Publisher: MDPI
                ISSN (Electronic): 1420-3049
                Publication date (Electronic): 13 August 2020
                Publication date Collection: August 2020
                Volume: 25
                Issue: 16
                Electronic Location Identifier: 3695
                Affiliations
                [1 ]Research Center for Biomedical Engineering, University of London, Northampton Square, London EC1V 0HB, UK; mohammad.mamouei@ 123456city.ac.uk (M.M.); karthik.budidha@ 123456city.ac.uk (K.B.); meha.qassem@ 123456city.ac.uk (M.Q.); p.kyriacou@ 123456city.ac.uk (P.A.K.)
                [2 ]Interdisciplinary Research Centre (IRC) in Biomedical Materials, Queen Mary University of London, Mile End Road, London E1 4NS, UK; p.vadgama@ 123456qmul.ac.uk
                Author notes
                [* ]Correspondence: nystha.baishya@ 123456city.ac.uk ; Tel.: +44-(0)20-7040-3878
                Author information
                https://orcid.org/0000-0002-2231-6132
                https://orcid.org/0000-0002-6329-8399
                https://orcid.org/0000-0001-6696-6017
                https://orcid.org/0000-0002-2868-485X
                Article
                Publisher ID: molecules-25-03695
                DOI: 10.3390/molecules25163695
                PMC ID: 7466057
                PubMed ID: 32823662
                SO-VID: 5e6cf66b-156c-459e-9c8a-7b6c690eb7a9
                Copyright © © 2020 by the authors.
                License:

                Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license ( http://creativecommons.org/licenses/by/4.0/).

                History
                Date received : 07 July 2020
                Date accepted : 12 August 2020
                Categories
                Subject: Article

                Keywords: lactate,lactic acid,infrared spectroscopy,atr,sepsis
                Data availability:
                Keywords: lactate, lactic acid, infrared spectroscopy, atr, sepsis

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