Phenotyping hyperlactataemic shock
Research type
Research Study
Full title
Could characterising different phenomes associated with hyperlactataemia allow better targeted therapy for patients in shocked states?
IRAS ID
269693
Contact name
Joseph Alderman
Contact email
Sponsor organisation
University of Birmingham
Duration of Study in the UK
0 years, 9 months, 4 days
Research summary
Research Summary
People suffering from certain severe illnesses have a high ‘lactate’ level (hyperlactataemia) in their blood. Lactate is a chemical produced by the body in times of stress. In the past, we thought that lactate was a waste product, but more recently we think lactate may have an important role to play in the body in certain circumstances. Doctors see high lactate levels in patients suffering from many conditions. When patient have high lactate levels it suggests they are more sick, and more likely to die from their illness.However, some people with high lactate levels do not suffer poor health. We don’t yet fully understand what lactate does, or why it indicates harm in only some cases.We will invite patients attending the emergency department at the Queen Elizabeth Hospital Birmingham to join our project. In total, 48 patients will be recruited: 16 with severe infections (sepsis), 16 with severe injuries (major trauma), and 16 with crisis of diabetes with very high blood sugar (diabetic ketoacidosis). They will be given written information to read, and will have time to ask questions. If they agree to take part, they will need to sign a consent form.
Two blood samples will be taken from the artery in the patient’s wrist - one immediately and one 24h later. This is a common medical test, and is very safe. It does sting slightly more than blood tests from the vein. Information about the patient related to the research will be recorded from their medical records. Information and blood samples will be moved to the University of Birmingham for analysis.This project will help improve our understanding of lactate, and hopefully tailor treatment for patients with high lactates towards them as an individual. It will also be the basis for our future research.
Summary of Results
Patients who are critically unwell often have high levels of a chemical called 'lactate' in their blood. This chemical has previously been assumed to be produced by the body when it is under stress. This study aimed to understand more about how this chemical affects the body, in particular whether it affects the way the immune system works. We used a technique to analyse the composition of blood samples in great detail. This showed that some people with high blood lactate levels have other changes in the composition of their blood, whilst others have blood which looks more like that from healthy people. Unfortunately this study commenced just at the start of the Covid-19 pandemic, and by the time the study ended we had only recruited 17 of the planned 48 patients. This means our study is not able to 'prove' that these differences are true, only that there is a signal here which may be worth exploring with future studies. The hope is that if we can identify which patients are the most unwell, we may be able to target treatments better, improving their chances of survival.REC name
Wales REC 4
REC reference
19/WA/0249
Date of REC Opinion
11 Sep 2019
REC opinion
Favourable Opinion