• Zhi Mao, Guoxiong Liu, Qing Yu, Shuang Qi, Yunchi Lou, Chao Liu, Qinglin Li, Chao Xue, Hongjun Kang, Quan Hong, and Feihu Zhou.
• Department of Critical Care Medicine, the First Medical Centre, Chinese PLA General Hospital, Beijing, China.
• Ann Transl Med. 2020 Oct 1; 8 (19): 1240.

BackgroundTo assess the association between serum lactate levels and intolerance to enteral nutrition (EN) in septic patients treated with vasopressors.MethodsThis retrospective study was conducted between January 1, 2015 and May 1, 2018 in an intensive care unit (ICU). Patients with sepsis who were given EN and treated with vasopressors were included. EmpowerStats software and R (version 3.3.2) was used to examine the association between serum lactate levels and intolerance to EN.ResultsAmong the 132 septic patients (age, 60.6±18.1 years) enrolled, 35 (26.5%) patients suffered intolerance to EN. Multiple logistic regression analysis demonstrated that an elevated lactate level was an independent risk factor for EN intolerance [odds ratio (OR): 2.7; 95% confidence interval (CI): 1.6-4.4; P<0.001]. The area under the receiver operating characteristic (ROC) curve for serum lactate levels was 0.764 (95% CI: 0.664-0.864). Stratified analysis suggested that age was the most prominent interactive factor for serum lactate levels in EN intolerance. Serum lactate levels were closely correlated to EN intolerance in elderly patients (age ≥65 years) (OR: 9.5; 95% CI: 2.1-42.4; P=0.0261 for interaction), while no such association was identified in younger patients (age <65 years; OR: 1.7; 95% CI: 1.0-2.9; P=0.052).ConclusionsSerum lactate levels were associated with an increased risk of EN intolerance in patients with sepsis, especially in elderly individuals. An elevated serum lactate level may be an early predictor of EN intolerance in elderly septic patients treated with vasopressors. However, further studies are called for to verify these findings.2020 Annals of Translational Medicine. All rights reserved.

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