Agreement Between Peripheral Venous and Arterial Lactate Levels
Autor: | Michael Touger, E. John Gallagher, Kevin Rodriguez |
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Rok vydání: | 1997 |
Předmět: |
Adult
Male medicine.medical_specialty Time Factors Adolescent Sensitivity and Specificity Likelihood ratios in diagnostic testing Veins Cohort Studies Intensive care Internal medicine Confidence Intervals medicine Humans Prospective Studies Vein Aged business.industry Metabolic disorder Arteries Middle Aged Tourniquets medicine.disease Confidence interval Surgery Peripheral medicine.anatomical_structure Multivariate Analysis Cohort Lactates Emergency Medicine Cardiology Acidosis Lactic Female Blood Gas Analysis business Artery |
Zdroj: | Annals of Emergency Medicine. 29:479-483 |
ISSN: | 0196-0644 |
DOI: | 10.1016/s0196-0644(97)70220-8 |
Popis: | Study objective: To test the hypothesis that measurements of peripheral venous lactate (V-LACT) can be substituted for arterial lactate (A-LACT) in predicting arterial hyperlactacidemia. Methods: We conducted a prospective comparison of paired A-LACT and V-LACT measurements obtained from a convenience sample of 74 ED patients who presented to an urban, public teaching hospital, 70% of whom had abnormal A-LACT. Results: Mean A-LACT and V-LACT were 2.8 mmol/L and 3.0 mmol/L, respectively. A-LACT and V-LACT were strongly correlated ( r 2 =.89). Simultaneous multivariate adjustment for tourniquet time and for time elapsed between drawing of A-LACT and V-LACT had no effect on this correlation. Although the mean difference between V-LACT and A-LACT was only .22 mmol/L, the range that included 95% of the disagreement between paired measurements in individual patients was −1.3 mmol/L to 1.7 mmol/L. When A-LACT and V-LACT levels were each divided into normal and abnormal (elevated) groups, V-LACT showed 94% sensitivity (95% confidence interval [CI], 83% to 99%), 57% specificity (95% CI, 34% to 78%), a positive likelihood ratio of 2.2, and a negative likelihood ratio of .1. A-LACT values were used as the criterion standard for these calculations. Conclusion: Correlation between A-LACT and V-LACT was high in this cohort of patients, but agreement is imperfect. The odds of arterial hyperlactacidemia appear to be reduced substantially by the finding of a normal V-LACT but are only marginally increased if the V-LACT is increased. Caution should be used in the routine substitution of V-LACT for A-LACT. [Gallagher EJ, Rodriguez K, Touger M: Agreement between peripheral venous and arterial lactate levels. Ann Emerg Med April 1997; 29:479-483.] |
Databáze: | OpenAIRE |
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