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Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine

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Open Access 01-12-2016 | Original research

Capillary lactate concentration on admission of normotensive trauma patients: a prospective study

Authors: Pierre Bouzat, Clotilde Schilte, Marc Vinclair, Pauline Manhes, Julien Brun, Jean-Luc Bosson, Jean-François Payen

Published in: Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine | Issue 1/2016

Abstract

Background

Elevated serum blood lactate is an indicator of on-going bleeding in severe trauma patients. Point-of-care (POC) capillary lactate measurement devices may be useful to rapidly assess lactate concentration at the bedside. The aim of this study was to test the diagnostic performance of capillary lactate to predict significant transfusion in normotensive trauma patients.

Methods

We conducted a prospective observational study in one level-I trauma centre. From August 2011 to February 2013, 120 consecutive adult patients with systolic blood pressure (SBP) higher than 90 mmHg were included. Capillary lactate was measured on admission in the trauma bay. The primary outcome was defined as a significant transfusion within the first 48 h. Diagnostic performance was determined using receiver operating characteristic (ROC) curve analysis. We also tested the agreement between capillary lactate and blood lactate concentrations using Bland and Altman analysis.

Results

Of the 120 normotensive trauma patients, 30 (25 %) required at least one unit of packed red blood cells (RBC) and 12 (10 %) patients received at least four RBC within the first 48 h. All patients with significant RBC transfusion had capillary lactate higher than 3.5 mmol/l. The area under the ROC curve of capillary lactate on admission to predict transfusion of at least 4 RBC units was 0.68 [95 % CI 0.58 – 0.78]. The average bias between capillary and blood lactate measurements was 2.4 mmol/l with a standard deviation of 3.0 mmol/l (n = 60 patients).

Conclusions

Although a significant association was found between POC lactate concentration and transfusion requirements, the diagnostic performance of capillary lactate measurements was poor. Due to large disagreement between capillary lactate and blood lactate, capillary lactate cannot be considered in the clinical setting.

Trial registration

ClinicalTrials.gov, No. NCT01793428.

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Title: Capillary lactate concentration on admission of normotensive trauma patients: a prospective study
Authors: Pierre Bouzat
Clotilde Schilte
Marc Vinclair
Pauline Manhes
Julien Brun
Jean-Luc Bosson
Jean-François Payen
Publication date: 01-12-2016
Publisher: BioMed Central
Published in: Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine / Issue 1/2016
Electronic ISSN: 1757-7241
DOI: https://doi.org/10.1186/s13049-016-0272-x

Keynote webinar | Spotlight on sleep in brain health

Springer Medicine

Capillary lactate concentration on admission of normotensive trauma patients: a prospective study

Abstract

Background

Methods

Results

Conclusions

Trial registration

Keynote webinar | Spotlight on sleep in brain health

Springer Medicine

Abstract

Background

Methods

Results

Conclusions

Trial registration

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