The use of finger-stick blood to assess lactate in critically ill surgical patients

Sabat, Joseph; Gould, Scott; Gillego, Ezra; Hariprashad, Anita; Wiest, Christine; Almonte, Shailyn; Lucido, David; Gave, Asaf; Leitman, I. Michael; Eiref, Simon D.

doi:10.1016/j.amsu.2016.07.021

Cited by 8 publications

(4 citation statements)

References 15 publications

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“…In our study, ICU patients had higher capillary blood lactate than arterial blood lactate but almost the same as venous blood lactate. Studies performed with other handheld devices in ICU populations also report good agreement between capillary and arterial lactate, but these devices were validated in lower lactate ranges [21][22][23].…”

Section: Discussionmentioning

confidence: 99%

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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: Discussionmentioning

confidence: 99%

“…Studies performed with other handheld devices in ICU populations also report good agreement between capillary and arterial lactate, but these devices were validated in lower lactate ranges [ 21 – 23 ].…”

Section: Discussionmentioning

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

View full text Add to dashboard Cite

show abstract

“…Studies performed with other handheld devices in ICU populations also report good agreement between capillary and arterial lactate, but the devices were validated in lower lactate ranges (20)(21)(22).…”

Section: Discussionmentioning

confidence: 99%

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

Raa

Sunde

Bolann

et al. 2020

Preprint

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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. Results: A total of 49 intensive care patients with elevated lactate and 11 healthy volunteers who performed a maximal oxygen consumption test to obtain elevated blood lactate levels were included. 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% to45%), p<0.001) higher, respectively, than the corresponding 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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“…Поскольку лактат является стандартным лабораторным тестом, он может служить в качестве более объективного суррогата перфузии тканей по сравнению с физикальным осмотром или скоростью диуреза. При концентрации лактата более 4 ммоль/л смертность от септического шока превышает 50 % [2], уровень лактата и клиренс лактата широко используются в качестве прогностического критерия смертности [3][4][5][6][7][8]. Стоит отметить, что авторы в разных исследованиях измеряли уровень лактата крови, забранной из различных сосудов: артериальной крови или смешанной венозной крови.…”

Section: Introductionunclassified

Выбор Источника Забора Крови Для Измерения Уровня Лактата У Пациентов С Септическим Шоком

Zuo¹,

Глумчер²,

Дубров³

2021

ЕМ

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The initial lactate level has been used as one of mortality predictors in patients with septic shock. Different studies measured the concentrations of blood lactate obtained from different vessels. Even in some retrospective studies, blood lactate levels from heterogeneous sources (artery, central vein, and peripheral vein) have been used. Practicing physicians face following questions: what data have the best predictive value, can they replace each other? In our observations, а high positive linear correlation was found between lactate concentrations in arterial and central venous blood (R = 0.895; P < 0.001). Both indicators have satisfactory values for predicting treatment outcome. Lactate level in arterial blood had a slightly better predictive value compared to its concentration in central venous blood.

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The use of finger-stick blood to assess lactate in critically ill surgical patients

Cited by 8 publications

References 15 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)

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

Выбор Источника Забора Крови Для Измерения Уровня Лактата У Пациентов С Септическим Шоком

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