Article Sidebar

Submitted
31 October 2017
Accepted
31 October 2017
Published
3 November 2017
Download
PDF
Statistic
Read Counter : 1246 Download : 639

Main Article Content

Abstract

Urosepsis occurs in 20-30 % of septic case. Early diagnosis were undoubtfully important to improve the results of sepsis management. Bacteriological confirmation may be difficult to obtain and negative cultures do not exclude the presence of infection. Increased understanding of inflammatory cascade mechanisms provided several indicator of infection and prognosis. Lactate measurement in patients with infection and possibly severe sepsis to help identify patients at high risk of death in order to apply aggressively therapy. Elevation in serum C-reactive protein (CRP) is also associated with an increasing risk of death in patients with infection. This study was to determine the plasma lactate and CRP levels of patients with urosepsis as a prognostic indicator. This is an analytic observational study to compare the correlation and significance of plasma lactate and CRP with prognosis of urosepsis. Each subject was measured for plasma lactate and serum CRP at time of admission. All subjects were managed according to standard protocol. At the 14th day of treatment, patients were evaluated with a clinical severity score. The outcome was classified as follows: 1=good condition/improved, 2=morbid/worsened and 3=death. The statistical analysis used Spearman's rho test, Ï<0.05 was considerated to indicate significance. We enrolled 25 subjects with urosepsis. 14 patients who were septic, nine patients had severe sepsis and 2 patients had septic shock. Mean plasma lactate level in patients based on outcome (improved/worsened/death) was 2.08 mmol/L; 4.16 mmol/L and 5.27 mmol/L. The mean value of CRP was 13.41 mg/L; 22.28 mg/L and 24.62 mg/L. These were statistically significant (p 0.008 vs 0.016) in determining the outcome of the urosepsis patient. The coefficient correlation is better with plasma lactate than CRP (0.517 vs 0.475). In conclusion, the measurement of plasma lactate and CRP level can be used as a prognostic marker for the outcome of patient with urosepsis. Plasma lactate showed higher correlation with outcome of urosepsis than CRP.

Keywords

Plasma lactate CRP Urosepsis

Article Details

License

  • Folia Medica Indonesiana is a scientific peer-reviewed article which freely available to be accessed, downloaded, and used for research purposes. Folia Medica Indonesiana (p-ISSN: 2541-1012; e-ISSN: 2528-2018) is licensed under a Creative Commons Attribution 4.0 International License. Manuscripts submitted to Folia Medica Indonesiana are published under the terms of the Creative Commons License. The terms of the license are:

    Attribution ” You must give appropriate credit, provide a link to the license, and indicate if changes were made. You may do so in any reasonable manner, but not in any way that suggests the licensor endorses you or your use.

    NonCommercial ” You may not use the material for commercial purposes.

    ShareAlike ” If you remix, transform, or build upon the material, you must distribute your contributions under the same license as the original.

    No additional restrictions ” You may not apply legal terms or technological measures that legally restrict others from doing anything the license permits.

    You  are free to :

    Share ” copy and redistribute the material in any medium or format.

    Adapt ” remix, transform, and build upon the material.

How to Cite
Prilistiyo, D. I., Santoso, A., Anniwati, L., & Pudjirahardjo, W. J. (2017). PLASMA LACTATE VERSUS C-REACTIVE PROTEIN AS PROGNOSITIC INDICATOR IN UROSEPSIS. Folia Medica Indonesiana, 53(2), 113–117. https://doi.org/10.20473/fmi.v53i2.6354
Download Citation
Endnote/Zotero/Mendeley (RIS)
BibTeX

References

  1. Bakker J, Maarten WN, Jansen T (2013). Clinical use lactate minitoring in critically ill patients. Annals of Intensive Care Vol 3, 12
  2. Bochud C (2003). Science, medicine and the future: pathogenesis of sepsis: new concepts and implications for future treatment. BMJ Vol 326, 262-6
  3. Bone RC, Balk R, Cerra FB, et al (1992). Definitions for sepsis and organ failure and guidelines for the use of innovative therapies in Sepsis. J Chest Vol 101, 1644-55
  4. Gladden (2004). Lactate metabolism: A new paradigm for the third millennium. Journal of Physiology Vol 558, 5-30
  5. Kalra OP and Raizada A (2009). Approach to patient with urosepsis. Journal of Global Infectious Disease Vol 1, 57-63
  6. Lever A, Mackenzie I (2007). Sepsis: definition, epidemiology, and diagnosis. BMJ Vol 335(7625), 879-83
  7. Marx G, Reinhart K (2008). Urosepsis: from the intensive care viewpoint. Int J Antimicrob Agents Vol 1, S79-84
  8. Schaeffer AJ, Schaeffer E (2010). Infections of the urinary tract Cambell-Walsh Urology, Ch 8; 10th Ed, 287-9
  9. Schiefer HG, Diemer TH (2007). Urosepsis; Emergencies in urology. Springer – Verlag. Ch 5, 45-9
  10. Schuetz P, Crain MC, Muller B (2008). Procalcitonin and other biomarkers for the assessment of disease severity and guidance of treatment in bacterial infections. Advances in Sepsis Vol 6, 82-9
  11. Shapiro, Howell MD (2005). Serum Lactate as Predictor of Mortality in Emergency Dept. patients with Infection. Ann Emerg Med. 45:524-8
  12. Suzana MA, Francisco RM, Daliana PB, et al. (2003). C-reactive protein levels correlate with mortality and organ failure in critically ill patients. American Collage of Chest Physicians Vol 123, 2043-2049
  13. Vincent JL, Beumier M (2013). Diagnostic and prognostic markers in sepsis. Expert Rev Anti Infect Ther. Mar Vol 11(3), 265-75
  14. Von Landenberg P, Shoenfeld Y (2001). New approaches in the diagnosis of sepsis. Isr Med Assoc J. Jun Vol 3(6), 439-42
  15. Wagenlehner FM, Pilatz A, Naber KG, et al (2008). Therapeutic challenges of urosepsis. Eur J Clin Invest. Oct 38 Suppl 2, 45-9