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Blood Lactate Is a Useful Indicator for the Medical Emergency Team


Affiliations
1 Department of Anesthesiology and Intensive Care, Ostersund Hospital, 83183 Ostersund, Sweden
2 Department of Surgical and Perioperative Sciences, Umea University, 90185 Umea, Sweden
3 Department of Surgical Sciences, Anesthesiology and Critical Care Medicine, Uppsala University, 75185 Uppsala, Sweden
 

Lactate has been thoroughly studied and found useful for stratification of patientswith sepsis, in the IntensiveCareUnit, and trauma care. However, little is known about lactate as a risk-stratificationmarker in theMedical Emergency Team- (MET-) call setting.We aimed to determine whether the arterial blood lactate level at the time of a MET-call is associated with increased 30-day mortality. This is an observational study on a prospectively gathered cohort at a regional secondary referral hospital. AllMET-calls during the two-year study period were eligible. Beside blood lactate, age and vital signs were registered at the call. Among the 211 calls included, there were 64 deaths (30.3%). Median lactate concentration at the time of the MET-call was 1.82mmol/L (IQR 1.16-2.7). We found differences between survivors and nonsurvivors for lactate and oxygen saturation, a trend for age, but no significant correlations between mortality and systolic blood pressure, respiratory rate, and heart rate. As compared to normal lactate (<2.44mmol/L), OR for 30-daymortality was 3.54 (p < 0.0006) for lactate 2.44-5.0mmol/L and 4.45 (p < 0.0016) for lactate > 5.0mmol/L. The present results support that immediate measurement of blood lactate inMET call patients is a useful tool in the judgment of illness severity.
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  • Blood Lactate Is a Useful Indicator for the Medical Emergency Team

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Authors

Maria Schollin-Borg
Department of Anesthesiology and Intensive Care, Ostersund Hospital, 83183 Ostersund, Sweden
Par Nordin
Department of Surgical and Perioperative Sciences, Umea University, 90185 Umea, Sweden
Henrik Zetterstrom
Department of Surgical Sciences, Anesthesiology and Critical Care Medicine, Uppsala University, 75185 Uppsala, Sweden
Joakim Johansson
Department of Anesthesiology and Intensive Care, Ostersund Hospital, 83183 Ostersund, Sweden

Abstract


Lactate has been thoroughly studied and found useful for stratification of patientswith sepsis, in the IntensiveCareUnit, and trauma care. However, little is known about lactate as a risk-stratificationmarker in theMedical Emergency Team- (MET-) call setting.We aimed to determine whether the arterial blood lactate level at the time of a MET-call is associated with increased 30-day mortality. This is an observational study on a prospectively gathered cohort at a regional secondary referral hospital. AllMET-calls during the two-year study period were eligible. Beside blood lactate, age and vital signs were registered at the call. Among the 211 calls included, there were 64 deaths (30.3%). Median lactate concentration at the time of the MET-call was 1.82mmol/L (IQR 1.16-2.7). We found differences between survivors and nonsurvivors for lactate and oxygen saturation, a trend for age, but no significant correlations between mortality and systolic blood pressure, respiratory rate, and heart rate. As compared to normal lactate (<2.44mmol/L), OR for 30-daymortality was 3.54 (p < 0.0006) for lactate 2.44-5.0mmol/L and 4.45 (p < 0.0016) for lactate > 5.0mmol/L. The present results support that immediate measurement of blood lactate inMET call patients is a useful tool in the judgment of illness severity.