![]() ![]() This approach is associated with delays such as storing samples on ice to avoid increases in lactate due to ex-vivo anaerobic metabolism, transportation of samples to the laboratory and centrifugation before analysis leading to possible delays in the reporting of results to clinicians. The central laboratory approach involves transportation of blood samples to the laboratory via porters or air-tube systems. Lactate is measured using various analytical approaches including central laboratory methods, near patient blood gas analysers and portable Point Of Care (POC) handheld devices. Repeated and timely monitoring is therefore important in the management of patients with sepsis and in those with an elevated lactate. Persistent elevation of blood lactate of greater than 48 h in haemodynamically stable postoperative patients has been shown to be associated with an increased mortality rate. Early lactate clearance is associated with a decreased mortality rate in patients with severe sepsis. Elevated blood lactate is associated with mortality among critically ill patients. It is also an independent predictor of mortality and critical care admission. The POC handheld device produced accurate, efficient and timely lactate measurements with the potential to influence clinical decision making sooner.īlood lactate is a useful biomarker to identify patients at increased risk of mortality from sepsis. The median time for these samples from blood draw to availability of the central laboratory results at the clinical area was 133 min. In addition, 18 of our study samples were sent to the central laboratory for analysis due to a defect in the lactate module of OMNI S. ![]() The i-STAT was significantly quicker than both the GEM 4000 and the OMNIS (each p-value < 0.001). Median time from blood draw to OMNIS lactate results was 11 min (Q1–Q3 8–22). Median time from blood draw to GEM 4000 lactate results was 10 min (Q1–Q3 7.75–13). Median time from blood draw to i-STAT lactate results was 5 min (Q1–Q3 5–7). The Bland-Altman agreement method showed bias values of −0.03 and −0.24, between i-STAT and GEM 4000 and OMNI S respectively. Highly significant Pearson correlation coefficients (0.999 and 0.993 respectively) were found between i-STAT and GEM 4000 and OMNI S. Differential reporting times were assessed using Mann–Whitney test and descriptive statistics were reported with quartiles. For the second stage, we examined the differential reporting times of the POC device compared to the near patient blood gas analysers in two Scottish hospitals. Results were compared using Pearson correlation coefficient and Bland-Altman tests. For the first stage, blood samples were analysed on the i-STAT handheld device and the near patient blood gas analysers (GEM 4000 and OMNI S). MethodsĪ two-staged study method comparison and prospective observational stages, was conducted. The aims of this study were to a) compare the lactate measurement of a Point of Care (POC) handheld device to near patient blood gas analysers, and b) determine the differential reporting times between the analysers. ![]()
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