title: Point-of-care testing at triage decreases time to lactate level in septic patients.
abstract: 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.
authors.affiliation: Department of Emergency Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA.
authors.forename: Munish
authors.initials: M
authors.lastname: Goyal
authors.forename: Jesse M
authors.initials: JM
authors.lastname: Pines
authors.forename: Byron C
authors.initials: BC
authors.lastname: Drumheller
authors.forename: David F
authors.initials: DF
authors.lastname: Gaieski
mesh_terms: D000328:Adult; D000368:Aged; D019963:Clinical Chemistry Tests; D004636:Emergency Service, Hospital; D005260:Female; D006801:Humans; D019344:Lactic Acid / Q000097:blood*; D008297:Male; D008875:Middle Aged; D019095:Point-of-Care Systems; D011446:Prospective Studies; D018805:Sepsis / Q000097:blood* / Q000175:diagnosis*; D013997:Time Factors; D014218:Triage
chemical_list: D019344:Lactic Acid