• Sharon Tai-Passmann, Claire A D Slegers, Pleun Hemelaar, Nicole Waalders, Matty Koopmans, Bas van den Bogaard, Michiel van Lookeren Campagne, Jamilla Goedegebuur, Marnix Kuindersma, Nicolas Schroten, Fieke van der Elsen, Bart P X Grady, Wisse M F van den Beuken, Dorien Kiers, Peter Pickkers, van den OeverHuub L AHLAIntensive Care Department, Deventer Hospital, Nico Bolkesteinlaan 75, 7416, SE, Deventer, Netherlands; Intensive Care Department, Radboud university medical center, geert Grooteplein Zuid 10, 6525, GA, Nijmegen, Netherlands. Electr, and Research Collaboration Critical Care Netherlands (RCCNet), Piladys (PDE3i and lactate dynamics in septic shock) working group.
• Intensive Care Department, Deventer Hospital, Nico Bolkesteinlaan 75, 7416, SE, Deventer, Netherlands.
• J Crit Care. 2024 Oct 1; 83: 154827154827.

PurposeWe investigated the association between the administration of phosphodiesterase 3 inhibitors (PDE3i) and lactate kinetics, resolution of organ failure, ICU and hospital length of stay (LOS) and hospital mortality in a retrospective cohort of patients with septic shock and persistently elevated lactate concentrations.Material And MethodsPatients with septic shock and two arterial lactate concentrations ≥4 mmol/L with at least 4 h between measurements were eligible. Clinical data of the first four days of admission were collected in an online database. For each patient, the area between the actual lactate concentrations and 2.2 mmol/L (AUClact2.2), was calculated for three days.ResultsData on 229 patients from 10 hospitals were collected, of whom 123 received PDE3i (54%). First, a linear multivariate model was developed to predict AUClact2.2 (R2 = 0.57). Adding PDE3i as a cofactor did not affect R2. Second, 60 patients receiving PDE3i at any time between days 0 and 2 were compared to 60 propensity matched no-PDE3i patients. Third, 30 patients who received PDE3i from ICU admission to day 3 were compared to 30 propensity-matched no-PDE3i patients. These analyses showed no differences in AUClact2.2, SOFA scores, ICU or hospital LOS or hospital mortality between treatment groups.ConclusionsNo association was found between the administration of PDE3i and lactate kinetics, resolution of organ failure, ICU or hospital LOS or hospital mortality.Copyright © 2023. Published by Elsevier Inc.

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