title: Peripheral venous and arterial lactate agreement in septic patients in the emergency department: a pilot study.
abstract: Lactate measurements are routinely used in sepsis for prognostication and for guiding treatment. Although venous lactate measurements have widely been used, most studies have used arterial lactate (A-LACT). The interchangeability between the measurements is debatable. This pilot study aimed to investigate whether an agreement exists between peripheral venous lactate (PV-LACT) and A-LACT with respect to sepsis in the Emergency Department (ED). PV-LACT lactate and A-LACT measurements were taken from a convenience sample of 37 patients presenting to a tertiary hospital ED between November 2010 and August 2011. The agreement between the paired measurements was assessed using Bland-Altman analysis. The mean difference between the measurements (venous-arterial) was 0.54 mmol/l, with 95% limits of agreement of -0.11 to 1.18 mmol/l. This pilot study demonstrates the potential use of PV-LACT as a substitute for A-LACT measurement in septic ED patients. However, further definitive investigation is needed to support widespread clinical adoption of peripheral venous lactate.
authors.affiliation: aCollege of Medicine and Veterinary Medicine bWellcome Trust Clinical Research Facility, Western General Hospital, University of Edinburgh cEmergency Medicine Research Group Edinburgh (EMeRGE), Department of Emergency Medicine, Royal Infirmary of Edinburgh, Little France Crescent, Edinburgh, Scotland.
authors.forename: Robert
authors.initials: R
authors.lastname: Browning
authors.forename: Deepankar
authors.initials: D
authors.lastname: Datta
authors.forename: Alasdair J
authors.initials: AJ
authors.lastname: Gray
authors.forename: Catriona
authors.initials: C
authors.lastname: Graham
mesh_terms: D001158:Arteries; D004636:Emergency Service, Hospital / Q000706:statistics & numerical data; D005260:Female; D006801:Humans; D019344:Lactic Acid / Q000097:blood*; D008297:Male; D008875:Middle Aged; D010865:Pilot Projects; D011446:Prospective Studies; D018805:Sepsis / Q000097:blood*; D014680:Veins
chemical_list: D019344:Lactic Acid