title: Blood Lactate Is a Useful Indicator for the Medical Emergency Team.
abstract: Lactate has been thoroughly studied and found useful for stratification of patients with sepsis, in the Intensive Care Unit, and trauma care. However, little is known about lactate as a risk-stratification marker in the Medical Emergency Team- (MET-) call setting. We aimed to determine whether the arterial blood lactate level at the time of a MET-call is associated with increased 30-day mortality. This is an observational study on a prospectively gathered cohort at a regional secondary referral hospital. All MET-calls during the two-year study period were eligible. Beside blood lactate, age and vital signs were registered at the call. Among the 211 calls included, there were 64 deaths (30.3%). Median lactate concentration at the time of the MET-call was 1.82 mmol/L (IQR 1.16-2.7). We found differences between survivors and nonsurvivors for lactate and oxygen saturation, a trend for age, but no significant correlations between mortality and systolic blood pressure, respiratory rate, and heart rate. As compared to normal lactate (<2.44 mmol/L), OR for 30-day mortality was 3.54 (p < 0.0006) for lactate 2.44-5.0 mmol/L and 4.45 (p < 0.0016) for lactate > 5.0 mmol/L. The present results support that immediate measurement of blood lactate in MET call patients is a useful tool in the judgment of illness severity.
authors.affiliation: Department of Anesthesiology and Intensive Care, Östersund Hospital, 83183 Östersund, Sweden.
authors.forename: Maria
authors.initials: M
authors.lastname: Schollin-Borg
authors.affiliation: Department of Surgical and Perioperative Sciences, Umeå University, 90185 Umeå, Sweden.
authors.forename: Pär
authors.initials: P
authors.lastname: Nordin
authors.affiliation: Department of Surgical Sciences, Anesthesiology and Critical Care Medicine, Uppsala University, 75185 Uppsala, Sweden.
authors.forename: Henrik
authors.initials: H
authors.lastname: Zetterström
authors.affiliation: Department of Anesthesiology and Intensive Care, Östersund Hospital, 83183 Östersund, Sweden; Department of Surgical and Perioperative Sciences, Anesthesiology and Intensive Care, Unit of Research, Education and Development-Östersund, Umeå University, 83183 Östersund, Sweden.
authors.forename: Joakim
authors.initials: J
authors.lastname: Johansson