Lactate measurement in pre-hospital care: a review of the literature

Abstract

Background: Lactate has been identified as a useful marker of shock. Lactate can be measured in the pre-hospital environment rapidly and accurately. Method: A comprehensive literature search was conducted using a targeted search strategy. Additional literature was located through reference list searching and prior awareness by the authors. This identified a number of papers which were appraised for relevance. This appraisal identified 29 papers which were included in the review. Conclusion: Lactate has been shown to be measurable in the pre-hospital environment and to be prognostic of mortality. Lactate measurement needs to be linked to specific treatment algorithms with improved outcomes for patients in order to justify inclusion in pre-hospital practice.

Evaluation of pre-hospital point-of-care testing for lactate in sepsis and trauma patients

“…One of the criteria for severe sepsis on the SST is a lactate of >2 mmol/L, which NEAS paramedics have previously been unable to measure. The potential use of lactate in pre-hospital care has been reported elsewhere by the authors (McClelland et al, 2012) and provided some of the background for this study.…”