Accuracy of Handheld Point-of-Care Fingertip Lactate Measurement in the Emergency Department

Sepsis is the body’s overwhelming and life-threatening response to infection that can lead to tissue damage, organ failure, and death. When associated with organ dysfunction, sepsis is considered severe and is accompanied by an increased risk of mortality. Early recognition of elevated lactate levels in sepsis may accelerate the detection of patients suitable for aggressive resuscitation. Gaieski  et al. examined the accuracy and time-saving effect of a handheld point-of-care device for the measurement of blood lactate as compared with reference laboratory testing in critically ill Emergency Department patients.

Gaieski  et al. carried out a prospective, observational study in a tertiary care US hospital. Consenting patients underwent fingertip point-of-care lactate measurements with a handheld device and simultaneous whole blood sampling for analysis by both the portable device and a standard laboratory analyser. The results were compared by intraclass correlation (ICC) and Bland and Altman plots. Differences in time to test result were compared by paired t test.

Twenty-four patients, 19 (79%) with sepsis and 21 (88%) with lactate levels below 4 mmol/L took part in the study, which was performed from April 2005 to May 2005.

The primary outcome measure was the accuracy of fingertip point-of-care lactate as compared to the reference laboratory testing. Secondary outcomes were the accuracy of whole blood point-of-care lactate measurements compared to the reference method, and the time differential from fingertip point-of-care lactate result to laboratory reference method result

The authors concluded that fingertip point-of-care lactate measurement is an accurate method to determine lactate levels in infected Emergency Department patients with normal or modestly elevated lactate values and significantly decreases time to test results.

This article was written by David F. Gaieski, Byron C. Drumheller, Munish Goyal, Barry D. Fuchs, Frances S. Shofer and Kara Zogby, and published in 2013 by Western Journal of Emergency Medicine

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Accuracy of Handheld Point-of-Care Fingertip Lactate Measurement in the Emergency Department