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

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 th...

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Autores principales: Kruse, Ole, Grunnet, Niels, Barfod, Charlotte
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2011
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3292838/
https://www.ncbi.nlm.nih.gov/pubmed/22202128
http://dx.doi.org/10.1186/1757-7241-19-74
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author Kruse, Ole
Grunnet, Niels
Barfod, Charlotte
author_facet Kruse, Ole
Grunnet, Niels
Barfod, Charlotte
author_sort Kruse, Ole
collection PubMed
description 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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spelling pubmed-32928382012-03-04 Blood lactate as a predictor for in-hospital mortality in patients admitted acutely to hospital: a systematic review Kruse, Ole Grunnet, Niels Barfod, Charlotte Scand J Trauma Resusc Emerg Med Review 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. BioMed Central 2011-12-28 /pmc/articles/PMC3292838/ /pubmed/22202128 http://dx.doi.org/10.1186/1757-7241-19-74 Text en Copyright ©2011 Kruse et al; licensee BioMed Central Ltd. http://creativecommons.org/licenses/by/2.0 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Review
Kruse, Ole
Grunnet, Niels
Barfod, Charlotte
Blood lactate as a predictor for in-hospital mortality in patients admitted acutely to hospital: a systematic review
title Blood lactate as a predictor for in-hospital mortality in patients admitted acutely to hospital: a systematic review
title_full Blood lactate as a predictor for in-hospital mortality in patients admitted acutely to hospital: a systematic review
title_fullStr Blood lactate as a predictor for in-hospital mortality in patients admitted acutely to hospital: a systematic review
title_full_unstemmed Blood lactate as a predictor for in-hospital mortality in patients admitted acutely to hospital: a systematic review
title_short Blood lactate as a predictor for in-hospital mortality in patients admitted acutely to hospital: a systematic review
title_sort blood lactate as a predictor for in-hospital mortality in patients admitted acutely to hospital: a systematic review
topic Review
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3292838/
https://www.ncbi.nlm.nih.gov/pubmed/22202128
http://dx.doi.org/10.1186/1757-7241-19-74
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