Lactate point-of-care testing for acidosis: Cross-comparison of two devices with routine laboratory results

Horssen, Remco van; Schuurman, Teska; Groot, M.J.M. de; Jakobs, Bernadette S.

doi:10.1016/j.plabm.2015.12.005

Cited by 13 publications

(7 citation statements)

References 26 publications

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“…The correlation and categorization of BLAC from both testing methods show that POCT can accurately measure blood lactic acid values in cancer patients. This finding is consistent with those from previous studies that have shown that a POC device can provide reliable blood lactic acid measurements in ED and delivery rooms [ 8 – 10 ]. The assessment of lactic acid by POCT in cancer patients can timely identify who is at risk for sepsis.…”

Section: Discussionsupporting

confidence: 93%

“…Previous studies have shown that POC devices are able provide reliable measurements of lactate levels in delivery rooms and emergency departments (ED) [ 8 – 10 ]. In the study reported here, we shift the focus to cancer patients who not only have cells producing more lactate but may be receiving treatment making them more susceptible to systemic infections.…”

Section: Introductionmentioning

confidence: 99%

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Value Added Impact of Both Point-of-Care and Laboratory Lactic Acid Analysis When Emergently Evaluating Cancer Patients

et al. 2020

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Introduction: Cancer patients are immunosuppressed and may present to an emergency department with atypical symptoms. In the emergency setting, it is important ascertain rapidly if lactic acid levels are high, either due to sepsis or tumor lysis syndrome, to effectively manage symptoms. Therefore, it is critical to determine the blood lactic acid level to timely identify who is at risk of sepsis and provide early intervention. We have compared blood lactic acid concentrations (BLAC) in cancer patients obtained by point-of-care testing (POCT) and those measured by laboratory analysis in blood samples drawn within a short time of each other. Methods: This was a retrospective study in cancer patients whose BLAC had been

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Section: Discussionsupporting

confidence: 93%

Section: Introductionmentioning

confidence: 99%

Value Added Impact of Both Point-of-Care and Laboratory Lactic Acid Analysis When Emergently Evaluating Cancer Patients

et al. 2020

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“…Bedside point-of-care lactate measurements have been shown to have excellent correlation with lab-reported lactate levels. 27 We included only the first lactate level and clinical impression obtained during any ED visit in the dataset, and for individuals with multiple ED visits during the study period, only the first lactate level and clinical impression of the most recent encounter was included. We excluded patients with a diagnosis of seizure because associated high lactate levels carry a very low mortality risk in that subset and prior lactate research studies have excluded patients with seizures 2,12 (Figure 1).…”

Section: Methodsmentioning

confidence: 99%

Age-adjusted and Expanded Lactate Thresholds as Predictors of All-Cause Mortality in the Emergency Department

Cannon

Miller

Grow

et al. 2020

WestJEM

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Introduction: While numerous studies have found emergency department (ED) lactate levels to be associated with increased in-hospital mortality, little information is available on the role age plays in this association. This study investigates whether age is a necessary variable to consider when using lactate levels as a marker of prognosis and a guide for management decisions in the ED. Methods: This was a retrospective cohort study in an urban, tertiary-care teaching hospital. A total of 13,506 lactate levels were obtained over a 4.5-year period. All adult patients who had a lactate level obtained by the treating provider in the ED were screened for inclusion. The main outcome measure was in-hospital mortality using age-adjusted cohorts and expanded lactate thresholds with secondary outcomes comparing mortality based on the primary clinical impression. Results: Of the 8796 patients in this analysis, there were 474 (5.4%) deaths. Mortality rates increased with both increasing lactate levels and increasing age. For all ages, mortality rates increased from 2.8% in the less than 2.0 millimoles per liter (mmol/L) lactate level, to 5.6% in the 2.0-2.9 mmol/L lactate level, to 8.0% in the 3.0-3.9 mmol/L lactate level, to 13.9% in the 4.0-4.9 mmol/L lactate level, to 13.7% in the 5.0-5.9 mmol/L lactate level, and to 39.1% in the 6.0 mmol/L or greater lactate level (p <0.0001). Survivors, regardless of age, had a mean lactate level <2.0 whereas nonsurvivors had mean lactate levels of 6.5, 4.5, and 3.7 mmol/L for age cohorts 18-39, 40-64, and ≥ 65 years, respectively. Conclusion: Our findings suggest that although lactate levels can be used as a prognostic tool to risk stratify ED patients, the traditional lactate level thresholds may need to be adjusted to account for varying risk based on age and clinical impressions. [West J Emerg Med. 2020;21(5)1249-1257.] readily be obtained and used to identify patients at high risk of death, even prior to the development of hemodynamic instability. Poor organ perfusion, if not reversed, ultimately leads to organ dysfunction and failure, shock, and potentially death. The use of lactate levels has been shown to be a predictor of prognosis in diverse populations of critically ill patients ranging from trauma to septic shock. 5-10 In the last decade, there has been increased use and evaluation of lactate in the ED and these studies demonstrate that elevated lactate levels are

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“…The measurement is based on an electrochemical reaction when lactate in whole blood reacts with the strip inserted in the SSX that 7 Feasibility of the SSX has been demonstrated in a prehospital setting, with acceptable reproducibility and concordance at clinically relevant concentrations compared to standard laboratory devices, albeit with proportional negative bias in higher concentrations. [15][16][17][18] The instrument was validated by the EMS before the study. ED physicians have access to the EMS Ambulink records where the prehospital lactate value was visible.…”

Section: Prehospital Lactatementioning

confidence: 99%

Prehospital lactate levels in blood as a seizure biomarker: A multi‐center observational study

et al. 2021

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Objective The objective of this study was to assess the value of prehospital measurement of lactate level in blood for diagnosis of seizures in cases of transient loss of consciousness. Methods Between March 2018 and September 2019, prehospital lactate was measured with a point‐of‐care device by the emergency medical services in an area serving a population of 900 000. A total of 383 cases of transient loss of consciousness were identified and categorized as tonic‐clonic seizure (TCS), other seizure, syncope, or other cause, according to the final diagnosis in the electronic medical records system. Receiver operating characteristic curve analyses were used to identify the optimal lactate cut‐off. Results A total of 383 cases were included (135 TCS, 42 other seizure, 163 syncope, and 43 other causes). The median lactate level in TCS was 7.0 mmol/L, compared to a median of 2.0 mmol/L in all other cases (P < .001). The area under the curve (AUC) of TCS vs nonepileptic causes was 0.87 (95% confidence interval [CI] 0.83‐0.91). The optimal cut‐off (Youden index, 67.8%) was 4.75 mmol/L, with 79% sensitivity (95% CI 71‐85) and 89% specificity (95% CI 85‐93) for TCS. Significance Prehospital lactate can be a valuable tool for identifying seizures in transient loss of consciousness. For acceptable specificity, a higher cut‐off than that previously demonstrated for hospital‐based measurements must be used when values obtained close to the time of the event are interpreted.

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Lactate point-of-care testing for acidosis: Cross-comparison of two devices with routine laboratory results

Cited by 13 publications

References 26 publications

Value Added Impact of Both Point-of-Care and Laboratory Lactic Acid Analysis When Emergently Evaluating Cancer Patients

Value Added Impact of Both Point-of-Care and Laboratory Lactic Acid Analysis When Emergently Evaluating Cancer Patients

Age-adjusted and Expanded Lactate Thresholds as Predictors of All-Cause Mortality in the Emergency Department

Prehospital lactate levels in blood as a seizure biomarker: A multi‐center observational study

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