<?xml version="1.0" encoding="ISO-8859-1"?><article xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance">
<front>
<journal-meta>
<journal-id>0120-3347</journal-id>
<journal-title><![CDATA[Colombian Journal of Anestesiology]]></journal-title>
<abbrev-journal-title><![CDATA[Rev. colomb. anestesiol.]]></abbrev-journal-title>
<issn>0120-3347</issn>
<publisher>
<publisher-name><![CDATA[SCARE-Sociedad Colombiana de Anestesiología y Reanimación]]></publisher-name>
</publisher>
</journal-meta>
<article-meta>
<article-id>S0120-33472019000100041</article-id>
<article-id pub-id-type="doi">10.1097/cj9.0000000000000084</article-id>
<title-group>
<article-title xml:lang="en"><![CDATA[Lactate clearance: prognostic mortality marker in trauma patients]]></article-title>
<article-title xml:lang="es"><![CDATA[La depuración de lactato: marcador pronóstico de mortalidad en pacientes traumatizados]]></article-title>
</title-group>
<contrib-group>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Morales]]></surname>
<given-names><![CDATA[Carlos]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
<xref ref-type="aff" rid="Aaf"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Ascuntar]]></surname>
<given-names><![CDATA[Johana]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Londoño]]></surname>
<given-names><![CDATA[Jessica María]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Niño]]></surname>
<given-names><![CDATA[César Daniel]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[León]]></surname>
<given-names><![CDATA[Jimmy Paul]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
<xref ref-type="aff" rid="Aaf"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Bernal]]></surname>
<given-names><![CDATA[Elisa]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Vargas]]></surname>
<given-names><![CDATA[Cesar]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Jaimes]]></surname>
<given-names><![CDATA[Fabián]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
<xref ref-type="aff" rid="Aaf"/>
<xref ref-type="aff" rid="A a"/>
<xref ref-type="aff" rid="A4"/>
</contrib>
</contrib-group>
<aff id="Af1">
<institution><![CDATA[,Universidad de Antioquia Department of General Surgery School of Medicine]]></institution>
<addr-line><![CDATA[Medellin ]]></addr-line>
<country>Colombia</country>
</aff>
<aff id="Af2">
<institution><![CDATA[,Hospital Universitario San Vicente Fundación  ]]></institution>
<addr-line><![CDATA[Medellin ]]></addr-line>
<country>Colombia</country>
</aff>
<aff id="Af3">
<institution><![CDATA[,Universidad de Antioquia  ]]></institution>
<addr-line><![CDATA[Medellin ]]></addr-line>
<country>Colombia</country>
</aff>
<aff id="Af4">
<institution><![CDATA[,Universidad de Antioquia School of Medicine Department of Internal Medicine]]></institution>
<addr-line><![CDATA[Medellin ]]></addr-line>
<country>Colombia</country>
</aff>
<pub-date pub-type="pub">
<day>00</day>
<month>03</month>
<year>2019</year>
</pub-date>
<pub-date pub-type="epub">
<day>00</day>
<month>03</month>
<year>2019</year>
</pub-date>
<volume>47</volume>
<numero>1</numero>
<fpage>41</fpage>
<lpage>48</lpage>
<copyright-statement/>
<copyright-year/>
<self-uri xlink:href="http://www.scielo.org.co/scielo.php?script=sci_arttext&amp;pid=S0120-33472019000100041&amp;lng=en&amp;nrm=iso"></self-uri><self-uri xlink:href="http://www.scielo.org.co/scielo.php?script=sci_abstract&amp;pid=S0120-33472019000100041&amp;lng=en&amp;nrm=iso"></self-uri><self-uri xlink:href="http://www.scielo.org.co/scielo.php?script=sci_pdf&amp;pid=S0120-33472019000100041&amp;lng=en&amp;nrm=iso"></self-uri><abstract abstract-type="short" xml:lang="en"><p><![CDATA[Abstract  Introduction: High lactate values are associated with adverse outcomes in almost all clinical situations, lactate levels above 2 mmol/L are proposed as an early and reliable marker of tissue hypoperfusion, and lactate clearance during treatment has also been proposed during resuscitation as a prognostic factor.  Objective: To determine the association between the initial value of lactate and its clearance after 6 and 24 hours in trauma patients with mortality.  Materials and methods: A subanalysis of a prospective cohort collected between March 2014 and October 2016 was carried out at the San Vicente Fundación University Hospital (Medellin, Colombia), with trauma patients over 18 years of age. Lactate and clinical variables were measured at admission, at 6 and at 24hours. The association of lactate levels at admission and clearance with in hospital mortality was estimated, using logistic regression models.  Results: A total of 251 patients met the inclusion criteria, 15.5% died, 45.4% required admission to intensive care, in patients who died the lactate at admission was 4.6mmol/L (Interquartile range = 2.9-6.9). The adjusted logistic regression model showed that lactate on admission, lactate clearance of 50% (0-24hours), trauma mechanism, and Sequential Organ Failure Assessment score were independent factors associated with mortality.  Conclusion: High values of lactate at admission are associated with greater probability of dying and its clearance is an independent factor of mortality in those who enter with high lactate values.]]></p></abstract>
<abstract abstract-type="short" xml:lang="es"><p><![CDATA[Resumen  Introducción: Valores elevados de lactato se relacionan con desenlaces adversos en casi todas las situaciones clínicas, los niveles de lactato por encima de 2mmol/L se proponen como marcador temprano y confiable de hipoperfusión tisular, igualmente se ha propuesto la depuración de lactato durante la reanimación como factor pronóstico.  Objetivo: Determinar en pacientes traumatizados la asociación del valor inicial de lactato y su depuración después de 6 y 24 horas con mortalidad.  Materiales y métodos: Se realizó un sub-análisis de una cohorte prospectiva recolectada entre marzo de 2.014 y octubre de 2.016 en el Hospital Universitario San Vicente Fundación (Medellín, Colombia), con pacientes mayores de 18 años poli traumatizados. Se midió el lactato y las variables clínicas al ingreso, a la hora 6 y a las 24. Se estimó la asociación con mortalidad hospitalaria, los niveles de lactato al ingreso y su depuración, mediante modelos de regresión logística.  Resultados: 251 pacientes cumplieron criterios de inclusión, el 15.5% fallecieron, el 45.4% requirieron ingreso a cuidados intensivos, en pacientes que murieron el lactato al ingreso fue de 4,6 mmol/L (IQR=2,9-6,9), en el modelo de regresión logística ajustado se encontró que el lactato al ingreso, la depuración de lactato del 50% (0-24 horas), el mecanismo de trauma y el puntaje de SOFA fueron factores independientes asociados con mortalidad.  Conclusión: Valores altos de lactato al ingreso se asocian con mayor probabilidad de morir y en quienes ingresan con valores de lactato elevados, su depuración es un factor independiente de mortalidad.]]></p></abstract>
<kwd-group>
<kwd lng="en"><![CDATA[Mortality]]></kwd>
<kwd lng="en"><![CDATA[Lactic Acid]]></kwd>
<kwd lng="en"><![CDATA[Prognosis]]></kwd>
<kwd lng="en"><![CDATA[Trauma Centers]]></kwd>
<kwd lng="en"><![CDATA[Inpatients]]></kwd>
<kwd lng="es"><![CDATA[Mortalidad]]></kwd>
<kwd lng="es"><![CDATA[Ácido láctico]]></kwd>
<kwd lng="es"><![CDATA[Pronóstico]]></kwd>
<kwd lng="es"><![CDATA[Centros Traumatológicos]]></kwd>
<kwd lng="es"><![CDATA[Pacientes Internos]]></kwd>
</kwd-group>
</article-meta>
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