Serum Lactate as Serum Biomarker for Cardiopulmonary Parameters within the First 24 Hours after a Spontaneous Intracerebral Hemorrhage

Abstract

Objective: Cardiopulmonary (CP) complications are well known in patients with an intracerebral hemorrhage (ICH) and could be associated with a higher serum lactate level. The present study aimed to assess the associations between the initial serum lactate level and the CP parameters within the first 24 h of intensive care unit (ICU) treatment in neurosurgical ICH patients. Patients and Methods: A total of 354 patients admitted to the ICU between 01/2009 and 12/2017 with a diagnosis of an ICH were retrospectively analyzed. Blood samples were taken upon admission, and each patient’s demographic, medical, and radiological data upon admission, as well as several CP parameters, were recorded within the first 24 h of ICU treatment. Results: A higher serum lactate level was associated with a lower GCS score (p < 0.0001), as well as a higher Acute Physiology and Chronic Health Evaluation II score (p = 0.002) upon admission. Additionally, patients with initially higher serum lactate levels had a significantly higher need for a norepinephrine application (p = 0.004) and inspiratory oxygen fraction (p = 0.03) within the first 24 h. Conclusion: Neurosurgical ICH patients with higher serum lactate levels upon admission require more CP support within the first 24 h of ICU treatment.

Keywords: NICU; intracerebral hemorrhage; serum biomarker; serum lactate.

Figure 1

Flowchart for the inclusion and exclusion criteria.

Figure 2

Association of the serum lactate level upon admission and NAR within the first 24 h. NAR: norepinephrine application rate, * level of significance.

Figure 3

Association of the serum lactate level upon admission and FiO2 within the first 24 h. FiO₂: inspiratory oxygen fraction, * level of significance.

Figure 4

Association of the serum lactate level upon admission and necessity of endotracheal intubation within the first 24 h, * level of significance.