Arterial lactate levels in an emergency department are associated with mortality: a prospective observational cohort study

Datta, Deepankar; Walker, Craig; Gray, Alasdair; Graham, Catriona

doi:10.1136/emermed-2013-203541

Cited by 45 publications

(49 citation statements)

References 22 publications

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“…The wide LoA indicates poor precision: CAP-LACT approximates PV-LACT to ±2 mmol/L, a large discrepancy making CAP-LACT measurement impractical with commonly accepted thresholds of 2 and 4 mmol/L 1. Four measurements with a large bias (figure 1) contributed to poor precision: the reasons for these large biases are unclear.…”

Section: Discussionmentioning

confidence: 99%

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Capillary and Venous Lactate Agreement: a pilot prospective observational study

et al. 2016

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Section: Discussionmentioning

confidence: 99%

“…Lactate is a biochemical marker used to identify unwell patients with potential poor clinical outcomes 1. To improve patient screening we require a method of measurement that is acceptable to the patient, causes minimal discomfort and minimises staff workload 2.…”

Section: Introductionmentioning

confidence: 99%

Capillary and Venous Lactate Agreement: a pilot prospective observational study

et al. 2016

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“…Objective evaluation of the severity of dyspnea is crucial in EDs, but unfortunately, we do not have any single, “magic” parameter which would describe correctly the severity of dyspnea. For objectification, a plausible solution is to choose pH, base excess (BE) and lactate levels in combination, because all of these are easily available in an emergency setting and characterize very well the severity of the patients’ different illnesses [17–25]. …”

Section: Introductionmentioning

confidence: 99%

Estimation of the severity of breathlessness in the emergency department: a dyspnea score

et al. 2016

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BackgroundDyspnea is a frequent complaint in emergency departments (ED). It has a significant amount of subjective and affective components, therefore the dyspnea scores, based on the patients’ rating, can be ambiguous. Our purpose was to develop and validate a simple scoring system to evaluate the severity of dyspnea in emergency care, based on objectively measured parameters.MethodsWe performed a double center, prospective, observational study including 350 patients who were admitted in EDs with dyspnea. We evaluated the patients’ subjective feeling about dyspnea and applied our Dyspnea Severity Score (DSS), rating the dyspnea in 7 Dimensions from 0 to 3 points. The DSS was validated using the deterioration of pH, base-excess and lactate levels in the blood gas samples (Objective Classification Scale (OCS) 9 points and 13 points groups).ResultsAll of the Dimensions correlated closely with the OCS values and with the subjective feeling of the dyspnea. Using multiple linear regression analysis we were able to decrease the numbers of Dimensions from seven to four without causing a significant change in the determination coefficient in any OCS groups. This reduced DSS values (exercise tolerance, cooperation, cyanosis, SpO2 value) showed high sensitivity and specificity to predict the values of OCS groups (the ranges: AUC 0.77–0.99, sensitivity 65–100%, specificity 64–99%). There was a close correlation between the subjective dyspnea scores and the OCS point values (p < 0.001), though the scatter was very large.ConclusionsA new DSS was validated which score is suitable to compare the severity of dyspnea among different patients and different illnesses. The simplified version of the score (its value ≥7 points without correction factors) can be useful at the triage or in pre-hospital care.

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“…Is a blood lactate of prognostic value in unselected ED patients? Two cohort studies of ED patients, one from Edinburgh12 and one from Odense in Denmark,13 published in this journal, may help us on that one.…”

Section: Prognosticmentioning

confidence: 99%

“…The study from Edinburgh looked at a cohort of patients presenting to the ED at the Royal Infirmary Edinburgh over a 3-month period, who had an arterial blood gas sample taken 12. They too used low, intermediate and high lactate categories.…”

Section: Prognosticmentioning

confidence: 99%