Peripheral venous and arterial lactate agreement in septic patients in the Emergency Department

Abstract

Lactate measurements are routinely used in sepsis for prognostication and for guiding treatment. Although venous lactate measurements have widely been used, most studies have used arterial lactate (A-LACT). The interchangeability between the measurements is debatable. This pilot study aimed to investigate whether an agreement exists between peripheral venous lactate (PV-LACT) and A-LACT with respect to sepsis in the Emergency Department (ED). PV-LACT lactate and A-LACT measurements were taken from a convenience sample of 37 patients presenting to a tertiary hospital ED between November 2010 and August 2011. The agreement between the paired measurements was assessed using Bland-Altman analysis. The mean difference between the measurements (venous-arterial) was 0.54 mmol/l, with 95% limits of agreement of -0.11 to 1.18 mmol/l. This pilot study demonstrates the potential use of PV-LACT as a substitute for A-LACT measurement in septic ED patients. However, further definitive investigation is needed to support widespread clinical adoption of peripheral venous lactate.