Is Serum Lactate Necessary in Patients with Normal Anion Gap and Serum Bicarbonate?

INTRODUCTION: There has been an increase in patients having serum lactate drawn in emergency situations. The objective of this study was to determine whether or not it was necessary to obtain a lactate level in patients with a normal serum bicarbonate level and anion gap. METHODS: This is a retrospe...

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Detalles Bibliográficos
Autores principales: Aronovich, Daniel, Trotter, Maykel, Rivera, Cynthia, Dalley, Michael, Farcy, David, Betancourt, Michel, Howard, Lydia, Licciardi, Sharon, Cubeddu, Luigi, Goldszer, Robert
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Department of Emergency Medicine, University of California, Irvine School of Medicine 2015
Materias:
Critical Care
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4427204/
https://www.ncbi.nlm.nih.gov/pubmed/25987907
http://dx.doi.org/10.5811/westjem.2015.2.23906
Descripción
Sumario:INTRODUCTION: There has been an increase in patients having serum lactate drawn in emergency situations. The objective of this study was to determine whether or not it was necessary to obtain a lactate level in patients with a normal serum bicarbonate level and anion gap. METHODS: This is a retrospective chart review evaluation of 304 patients who had serum lactate and electrolytes measured in an emergency setting in one academic medical center. RESULTS: In 66 patients who had elevated serum lactate (>2.2mmol/L), 45 (68%) patients had normal serum bicarbonate (SB) (greater than 21 mmol/L). Normal anion gap (AG) (normal range <16 mEq/l) was found in 51 of the 66 patients (77%). CONCLUSION: We found that among patients with elevated serum lactate, 77% had a normal anion gap and 68% had normal serum bicarbonate. We conclude serum lactate should be drawn based on clinical suspicion of anaerobic tissue metabolism independent of serum bicarbonate or anion gap values.

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