POINT-OF-CARE TESTING AT TRIAGE DECREASES TIME TO LACTATE LEVEL IN SEPTIC PATIENTS

被引:54
作者
Goyal, Munish [1 ]
Pines, Jesse M. [1 ]
Drumheller, Byron C. [1 ]
Gaieski, David F. [1 ]
机构
[1] Univ Penn, Dept Emergency Med, Philadelphia, PA 19104 USA
关键词
sepsis; lactate; triage; point-of-care systems; emergency medicine; BLOOD LACTATE; SEVERE SEPSIS; COSTS;
D O I
10.1016/j.jemermed.2007.11.099
中图分类号
R4 [临床医学];
学科分类号
1002 ; 100602 ;
摘要
Early recognition of elevated lactate levels may hasten the detection of time-sensitive illness. We studied a method to measure lactate levels in septic patients using a point-of-care (POC) device at Emergency Department triage. A convenience sample of adult patients with sepsis was enrolled. Consenting patients received a fingertip lactate measurement using a POC device. Treating clinicians were blinded to study and POC test results. Whole blood lactate levels were drawn at the discretion of the treating physician. A total of 238 patients were eligible; 154 (65%) consented, 5 left without treatment after consenting. Of the remaining 149, 44 (30%) patients received both POC and whole blood lactates. Median time from triage to POC lactate result was 21 min (interquartile range [IQR] 14-25). Median time from triage to whole blood lactate result was 172 min (IQR 119-256). The time difference between POC test result and whole blood lactate result was 151 min (IQR 101-247). Triage POC fingertip lactate is a feasible method for reducing time to identification of lactate levels in patients with sepsis. Larger studies are needed to determine the ability of POC lactate measurement to aid in the risk stratification of septic patients. (C) 2010 Elsevier Inc.
引用
收藏
页码:578 / 581
页数:4
相关论文
共 9 条
[1]   Epidemiology of severe sepsis in the United States: Analysis of incidence, outcome, and associated costs of care [J].
Angus, DC ;
Linde-Zwirble, WT ;
Lidicker, J ;
Clermont, G ;
Carcillo, J ;
Pinsky, MR .
CRITICAL CARE MEDICINE, 2001, 29 (07) :1303-1310
[2]   RETRACTED: Point-of-care (POC) testing of lactate in the intensive care patient - Accuracy, reliability, and costs of different measurement systems (Retracted article. See vol. 55, pg. 903, 2011) [J].
Boldt, J ;
Kumle, B ;
Suttner, S ;
Haisch, G .
ACTA ANAESTHESIOLOGICA SCANDINAVICA, 2001, 45 (02) :194-199
[3]  
GOYAL M, 2006, ANN EMERG MED, V48, P2
[4]   Examination of four different instruments for measuring blood lactate concentration [J].
Medbo, JI ;
Mamen, A ;
Olsen, OH ;
Evertsen, F .
SCANDINAVIAN JOURNAL OF CLINICAL & LABORATORY INVESTIGATION, 2000, 60 (05) :367-379
[5]   ST depression only on the initial 12-lead ECG: early diagnosis of acute myocardial infarction [J].
Menown, IBA ;
Allen, J ;
Anderson, JM ;
Adgey, AAJ .
EUROPEAN HEART JOURNAL, 2001, 22 (03) :218-227
[6]   Early goal-directed therapy in the treatment of severe sepsis and septic shock. [J].
Rivers, E ;
Nguyen, B ;
Havstad, S ;
Ressler, J ;
Muzzin, A ;
Knoblich, B ;
Peterson, E ;
Tomlanovich, M .
NEW ENGLAND JOURNAL OF MEDICINE, 2001, 345 (19) :1368-1377
[7]   Serum lactate as a predictor of mortality in emergency department patients with infection [J].
Shapiro, NI ;
Howell, MD ;
Talmor, D ;
Nathanson, LA ;
Lisbon, A ;
Wolfe, RE ;
Weiss, JW .
ANNALS OF EMERGENCY MEDICINE, 2005, 45 (05) :524-528
[8]   Validation of a hand-held lactate device in determination of blood lactate in critically injured patients [J].
Slomovitz, BM ;
Lavery, RF ;
Tortella, BJ ;
Siegel, JH ;
Bachl, BL ;
Ciccone, A .
CRITICAL CARE MEDICINE, 1998, 26 (09) :1523-1528
[9]  
[No title captured]