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Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine

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Open Access 01-12-2011 | Review

Blood lactate as a predictor for in-hospital mortality in patients admitted acutely to hospital: a systematic review

Authors: Ole Kruse, Niels Grunnet, Charlotte Barfod

Published in: Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine | Issue 1/2011

Abstract

Background

Using blood lactate monitoring for risk assessment in the critically ill patient remains controversial. Some of the discrepancy is due to uncertainty regarding the appropriate reference interval, and whether to perform a single lactate measurement as a screening method at admission to the hospital, or serial lactate measurements. Furthermore there is no consensus whether the sample should be drawn from arterial, peripheral venous, or capillary blood. The aim of this review was:

1) To examine whether blood lactate levels are predictive for in-hospital mortality in patients in the acute setting, i.e. patients assessed pre-hospitally, in the trauma centre, emergency department, or intensive care unit.

2) To examine the agreement between arterial, peripheral venous, and capillary blood lactate levels in patients in the acute setting.

Methods

We performed a systematic search using PubMed, Cochrane Central Register of Controlled Trials, Cochrane Database of Systematic Reviews, and CINAHL up to April 2011. 66 articles were considered potentially relevant and evaluated in full text, of these ultimately 33 articles were selected.

Results and Conclusion

The literature reviewed supported blood lactate monitoring as being useful for risk assessment in patients admitted acutely to hospital, and especially the trend, achieved by serial lactate sampling, is valuable in predicting in-hospital mortality. All patients with a lactate at admission above 2.5 mM should be closely monitored for signs of deterioration, but patients with even lower lactate levels should be considered for serial lactate monitoring. The correlation between lactate levels in arterial and venous blood was found to be acceptable, and venous sampling should therefore be encouraged, as the risk and inconvenience for this procedure is minimal for the patient. The relevance of lactate guided therapy has to be supported by more studies.

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Title: Blood lactate as a predictor for in-hospital mortality in patients admitted acutely to hospital: a systematic review
Authors: Ole Kruse
Niels Grunnet
Charlotte Barfod
Publication date: 01-12-2011
Publisher: BioMed Central
Published in: Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine / Issue 1/2011
Electronic ISSN: 1757-7241
DOI: https://doi.org/10.1186/1757-7241-19-74

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Blood lactate as a predictor for in-hospital mortality in patients admitted acutely to hospital: a systematic review

Abstract

Background

Methods

Results and Conclusion

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Abstract

Background

Methods

Results and Conclusion

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