Validation of a point-of-care capillary lactate measuring device (Lactate Pro 2).

Autor: Raa A; University of Bergen, Vognstølen 18 C, 5096, Bergen, Norway. anette.raa@live.no., Sunde GA; Department of Anaesthesia and Intensive Care, Haukeland University Hospital, Bergen, Norway.; Helicopter Emergency Medical Services, Bergen, Norway., Bolann B; Department of Clinical Science, University of Bergen, Bergen, Norway.; Department of Medical Biochemistry and Pharmacology, Haukeland University Hospital, Bergen, Norway., Kvåle R; Department of Anaesthesia and Intensive Care, Haukeland University Hospital, Bergen, Norway.; Department of Clinical Medicine, University of Bergen, Bergen, Norway., Bjerkvig C; Department of Anaesthesia and Intensive Care, Haukeland University Hospital, Bergen, Norway.; Helicopter Emergency Medical Services, Bergen, Norway.; Norwegian Navy Special Operations Commando, Norwegian Armed Forces, Bergen, Norway., Eliassen HS; Norwegian Navy Special Operations Commando, Norwegian Armed Forces, Bergen, Norway.; Haraldsplass Diaconal Hospital, Bergen, Norway., Wentzel-Larsen T; Centre for Child and Adolescent Mental Health, Eastern and Southern Norway, Oslo, Norway.; Norwegian Centre of Violence and Traumatic Stress Studies, Oslo, Norway.; Centre for Clinical Research, Haukeland University Hospital, Bergen, Norway., Heltne JK; Department of Anaesthesia and Intensive Care, Haukeland University Hospital, Bergen, Norway.; Helicopter Emergency Medical Services, Bergen, Norway.; Department of Clinical Medicine, University of Bergen, Bergen, Norway.
Jazyk: angličtina
Zdroj: Scandinavian journal of trauma, resuscitation and emergency medicine [Scand J Trauma Resusc Emerg Med] 2020 Aug 18; Vol. 28 (1), pp. 83. Date of Electronic Publication: 2020 Aug 18.
DOI: 10.1186/s13049-020-00776-z
Abstrakt: Background: The measurement of lactate in emergency medical services has the potential for earlier detection of shock and can be performed with a point-of-care handheld device. Validation of a point-of-care handheld device is required for prehospital implementation.
Aim: The primary aim was to validate the accuracy of Lactate Pro 2 in healthy volunteers and in haemodynamically compromised intensive care patients. The secondary aim was to evaluate which sample site, fingertip or earlobe, is most accurate compared to arterial lactate.
Methods: Arterial, venous and capillary blood samples from fingertips and earlobes were collected from intensive care patients and healthy volunteers. Arterial and venous blood lactate samples were analysed on a stationary hospital blood gas analyser (ABL800 Flex) as the reference device and compared to the Lactate Pro 2. We used the Bland-Altman method to calculate the limits of agreement and used mixed effect models to compare instruments and sample sites. A total of 49 intensive care patients with elevated lactate and 11 healthy volunteers with elevated lactate were included.
Results: There was no significant difference in measured lactate between Lactate Pro 2 and the reference method using arterial blood in either the healthy volunteers or the intensive care patients. Capillary lactate measurement in the fingertip and earlobe of intensive care patients was 47% (95% CI (29 to 68%), p < 0.001) and 27% (95% CI (11 to 45%), p < 0.001) higher, respectively, than the corresponding arterial blood lactate. In the healthy volunteers, we found that capillary blood lactate in the fingertip was 14% higher than arterial blood lactate (95% CI (4 to 24%), p = 0.003) and no significant difference between capillary blood lactate in the earlobe and arterial blood lactate.
Conclusion: Our results showed that the handheld Lactate Pro 2 had good agreement with the reference method using arterial blood in both intensive care patients and healthy volunteers. However, we found that the agreement was poorer using venous blood in both groups. Furthermore, the earlobe may be a better sample site than the fingertip in intensive care patients.
Databáze: MEDLINE
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