PubMed Health⌕ Search

Biomedical subjects

B N Cowan

Publications and source records attributed to B N Cowan.

3 recordsLinked to original sources

The relative prognostic value of lactate and haemodynamic measurements in early shock.

A prospective study was completed of 30 shocked patients admitted consecutively to an intensive therapy unit; the majority of the patients had shock of septic origin. Measurements were made of whole blood lactate together with mean arterial pressure, hourly urine volume and core: peripheral temperature difference at the start of treatment and 3 and 24 hours later. Serial lactate measurements were better at predicting outcome than single measurements. However, lactate measurements were much less valuable than serial measurements of the simple haemodynamic variables.

Blood Pressure↗

Metabolic acidosis in the critically ill.

The processes that lead to increased blood lactate concentration in shock and critical illness are complex. Although it is widely believed that lactic acidosis develops because of tissue hypoxia and reduced aerobic metabolism, a number of workers have shown that lactate oxidation rate is actually increased. Lactate production is also increased and this is probably the cause of increased blood lactate concentration. The clinical usefulness of lactate estimation in critical illness is also obscure. Suggestions that whole blood lactate concentration is an accurate predictor of the outcome of an episode of shock are unconvincing. At best this method may differentiate between groups of patients. However, the rate of improvement in lactate concentration with intensive resuscitation probably correlates better with survival, and further investigation of this possibility is suggested.

Acidosis↗