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The following is a summary of “Phosphodiesterase 3 inhibitors do not influence lactate kinetics and clinical outcomes in patients with septic shock: A multicentre cohort study,” published in the October 2024 issue of Critical Care by Tai-Passmann et al. 

Researchers conducted a retrospective study to evaluate the impact of phosphodiesterase 3 inhibitors (PDE3i) on lactate clearance, organ failure resolution, length of stay (LOS), and mortality in individuals with septic shock and elevated lactate levels.  

They included individuals with septic shock who had at least 2 arterial lactate levels ≥4 mmol/L measured at intervals of 4 hours or more. The clinical data from the first 4 days of admission were recorded in an online database. The area under the curve for lactate above 2.2 mmol/L (AUC_lact2.2) was calculated over 3 days.  

The results showed that data from 229 individuals across 10 hospitals were analyzed, with 123 (54%) receiving PDE3i. A linear multivariate model was created to predict the (AUC_lact2.2) for lactate above 2.2 mmol/L achieving an R² of 0.57, which remained unchanged after including PDE3i as a cofactor. A comparison was made between 60 individuals receiving PDE3i between days 0 and 2 and 60 propensity-matched individuals not receiving PDE3i. Another comparison involved 30 individuals given PDE3i from ICU admission to day 3 and 30 propensity-matched individuals without PDE3i. No significant differences were observed in AUC_lact2.2, SOFA scores, ICU or hospital LOS, or hospital mortality between the groups.  

Investigators concluded the PDE3i administration was not associated with improved lactate kinetics, organ failure resolution, ICU or hospital LOS, or mortality. 

Source: sciencedirect.com/science/article/abs/pii/S0883944124003149