title: Clinical evaluation of subcutaneous lactate measurement in patients after major cardiac surgery.
abstract: Minimally invasive techniques to access subcutaneous adipose tissue for glucose monitoring are successfully applied in type1 diabetic and critically ill patients. During critical illness, the addition of a lactate sensor might enhance prognosis and early intervention. Our objective was to evaluate SAT as a site for lactate measurement in critically ill patients. In 40 patients after major cardiac surgery, arterial blood and SAT microdialysis samples were taken in hourly intervals. Lactate concentrations from SAT were prospectively calibrated to arterial blood. Analysis was based on comparison of absolute lactate concentrations (arterial blood vs. SAT) and on a 6-hour lactate trend analysis, to test whether changes of arterial lactate can be described by SAT lactate. Correlation between lactate readings from arterial blood vs. SAT was highly significant (r2 = 0.71, P < .001). Nevertheless, 42% of SAT lactate readings and 35% of the SAT lactate trends were not comparable to arterial blood. When a 6-hour stabilization period after catheter insertion was introduced, 5.5% of SAT readings and 41.6% of the SAT lactate trends remained incomparable to arterial blood. In conclusion, replacement of arterial blood lactate measurements by readings from SAT is associated with a substantial shortcoming in clinical predictability in patients after major cardiac surgery.
authors: Department of Internal Medicine, Medical University Graz, Auenbruggerplatz 15, 8036 Graz, Austria.
authors: Martin
authors: M
authors: Ellmerer
authors: Martin
authors: M
authors: Haluzik
authors: Jan
authors: J
authors: Blaha
authors: Jaromir
authors: J
authors: Kremen
authors: Stepan
authors: S
authors: Svacina
authors: Andreas
authors: A
authors: Plasnik
authors: Dimas
authors: D
authors: Ikeoka
authors: Manfred
authors: M
authors: Bodenlenz
authors: Lukas
authors: L
authors: Schaupp
authors: Johannes
authors: J
authors: Plank
authors: Thomas R
authors: TR
authors: Pieber