Serum lactate as a predictor of early outcomes among trauma patients in Uganda

Okello, Michael; Makobore, Patson; Wangoda, Robert; Upoki, Alex; Galukande, Moses

doi:10.1186/s12245-014-0020-9

Cited by 24 publications

(22 citation statements)

References 21 publications

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“…Recent prehospital studies suggest that lactate may be more sensitive than SBP and HR in identifying haemorrhagic shock patients who may benefit from early blood transfusion, and suggest that lactate may be independent of conventional vital signs in identifying these patients [10][11][12][13][14]. Implementation of point of care lactate monitors in emergency medical services (EMS) may contribute to the evaluation of patients in the early stages of shock, thereby establishing a trigger for resuscitation [15,16].…”

Section: Introductionmentioning

confidence: 99%

Validation of a point-of-care capillary lactate measuring device (Lactate Pro 2)

Raa

Sunde

Bolann

et al. 2020

Scand J Trauma Resusc Emerg Med

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Background: The measurement of lactate in emergency medical services has the potential for earlier detection of shock and can be performed with a point-of-care handheld device. Validation of a point-of-care handheld device is required for prehospital implementation. Aim: The primary aim was to validate the accuracy of Lactate Pro 2 in healthy volunteers and in haemodynamically compromised intensive care patients. The secondary aim was to evaluate which sample site, fingertip or earlobe, is most accurate compared to arterial lactate. Methods: Arterial, venous and capillary blood samples from fingertips and earlobes were collected from intensive care patients and healthy volunteers. Arterial and venous blood lactate samples were analysed on a stationary hospital blood gas analyser (ABL800 Flex) as the reference device and compared to the Lactate Pro 2. We used the Bland-Altman method to calculate the limits of agreement and used mixed effect models to compare instruments and sample sites. A total of 49 intensive care patients with elevated lactate and 11 healthy volunteers with elevated lactate were included. Results: There was no significant difference in measured lactate between Lactate Pro 2 and the reference method using arterial blood in either the healthy volunteers or the intensive care patients. Capillary lactate measurement in the fingertip and earlobe of intensive care patients was 47% (95% CI (29 to 68%), p < 0.001) and 27% (95% CI (11 to 45%), p < 0.001) higher, respectively, than the corresponding arterial blood lactate. In the healthy volunteers, we found that capillary blood lactate in the fingertip was 14% higher than arterial blood lactate (95% CI (4 to 24%), p = 0.003) and no significant difference between capillary blood lactate in the earlobe and arterial blood lactate. Conclusion: Our results showed that the handheld Lactate Pro 2 had good agreement with the reference method using arterial blood in both intensive care patients and healthy volunteers. However, we found that the agreement was poorer using venous blood in both groups. Furthermore, the earlobe may be a better sample site than the fingertip in intensive care patients.

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Section: Introductionmentioning

confidence: 99%

Validation of a point-of-care capillary lactate measuring device (Lactate Pro 2)

Raa

Sunde

Bolann

et al. 2020

Scand J Trauma Resusc Emerg Med

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show abstract

“…Si bien hay aceptación en los beneficios de la depuración temprana de los niveles de lactato sérico elevados y como variable pronostica independiente [16][17] , no hay disponibles suficientes estudios de alta calidad que determinen la depuración del lactato sérico como un eje central en la reanimación en trauma 17 , los distintos autores concluyen que se deben realizar estudios de carácter prospectivo, para determinar sí se puede extrapolar la experiencia que se tiene sepsis 18 a los pacientes traumatizados, ya que podría usarse como un marcador pronostico sensible y de bajo costo en este tipo de pacientes. Actualmente se esta desarrollando un estudio de cohorte de carácter prospectivo en nuestra institución.…”

Section: Resultsunclassified

Vascular trauma and lactate clearance as predictor determining mortality. Case report.

Samaca¹,

Flórez²,

García³

et al. 2018

JOSHA

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“…found that patients with lactate above 2.0 mmol/L had 1.19 times risk of death within 72 h per unit increase in lactate. [ 7 ]…”

Section: Discussionmentioning

confidence: 99%

A clinical study on the initial assessment of arterial lactate and base deficit as predictors of outcome in trauma patients

Javali

Ravindra

Patil

et al. 2017

Indian Journal of Critical Care Medicine

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Background:Trauma is a leading cause of mortality in India. Outcomes can be improved by early recognition of hemorrhagic shock and expedited management. At present, we rely on traditional vital signs, which are not sensitive measures. Point of care biochemical markers have been emerging as prognostic markers in trauma, but have not been studied in Indian setting.Aims:This study aims to study the association between arterial lactate and base deficit (BD) at emergency department (ED) admission and 24 h outcome in trauma patients at risk of hemodynamic compromise.Materials and Methods:This was a prospective observational study on 100 trauma patients at risk of hemodynamic compromise in tertiary care center ED. Arterial blood gas analysis at admission and 24 h outcomes were noted and statistically analyzed.Results:Arterial lactate ≥4 mmol/L (sensitivity 100% and specificity 85.9%), BD ≥12 mEq/L (sensitivity 87.5% and specificity 82.6%) had more sensitivity than vital signs for predicting 24 h mortality. Higher lactate and BD were associated with increased blood transfusion requirement. Best cutoff values for predicting transfusion were lactate ≥2.9 mmol/L (sensitivity 65.2% and specificity 90.7%), BD ≥8 mEq/L (sensitivity 78.3% and specificity 75.9%). BD-based classification was comparable to ATLS classification in predicting mortality and determining transfusion requirements. Patients with higher arterial lactate and BD were found to have higher 24 h Intensive Care Unit (ICU) admission.Conclusion:Emergency admission arterial lactate and Base Deficit are useful predictors of mortality, need for blood transfusion and ICU admission at 24 h. It can be used to triage, identify shock early, assess transfusion requirement, and prognosticate trauma patients.

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Serum lactate as a predictor of early outcomes among trauma patients in Uganda

Cited by 24 publications

References 21 publications

Validation of a point-of-care capillary lactate measuring device (Lactate Pro 2)

Validation of a point-of-care capillary lactate measuring device (Lactate Pro 2)

Vascular trauma and lactate clearance as predictor determining mortality. Case report.

A clinical study on the initial assessment of arterial lactate and base deficit as predictors of outcome in trauma patients

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