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Validating a point of care lactate meter in adult patients with sepsis presenting to the emergency department of a tertiary care hospital of a low- to middle-income country

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Muhammad Akbar Baig1, Hira Shahzad2, Erfan Hussain3, Asad Mian4

 

1 Department of Emergency Medicine, Aga Khan University Hospital, Karachi 74800, Pakistan

 

2 Department of Medicine, Aga Khan University Hospital, Karachi 74800, Pakistan

 

3 Adult Critical Care Services, Aga Khan University Hospital, Karachi 74800, Pakistan

 

4 Department of Emergency Medicine, Pediatrics and Child Health, Aga Khan University Hospital, Karachi 74800, Pakistan

 

Corresponding Author: Muhammad Akbar Baig, Email: dr_akbar2007@hotmail.com

 

© 2017 World Journal of Emergency Medicine

 

DOI: 10.5847/wjem.j.1920–8642.2017.03.004

 

BACKGROUND: Timely identification of high blood lactate levels in septic patients may allow faster detection of those patients requiring immediate resuscitation. Point-of-care (POC) testing is being increasingly utilized in the emergency department (ED). We examined the accuracy and timesaving effect of a handheld POC lactate device for the measurement of fingertip and whole blood lactate as compared with reference laboratory blood testing in septic ED patients.

METHODS: A convenience sample of adult ED patients receiving serum lactate testing were enrolled prospectively in the ED of a multidisciplinary tertiary care hospital serving the population of one of the major cities of Pakistan. Participants underwent fingertip POC lactate measurement with a portable device and simultaneous whole blood sampling for analysis by both the POC lactate device and standard laboratory method. Lactate measurements were compared by intraclass correlation (ICC) and Bland and Altman plots.

RESULTS: Forty-three septic patients were included in the study. The fingertip POC & whole blood POC lactate measurements each correlated tightly with the reference method (ICC=0.93 & ICC=0.92, respectively). Similarly at 6 hours, the fingertip POC & whole blood POC lactate measurements demonstrated satisfactory correlation with the reference method (ICC=0.95 & ICC=0.97, respectively).

CONCLUSION: Fingertip POC lactate measurement is an accurate method to determine lactate levels in septic ED patients.

(World J Emerg Med 2017;8(3):184–189)

 

KEY WORDS: Sepsis; Point of care; Lactate; Emergency department; Pakistan

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