Colleagues, Our facility has recently implemented point of care arterial lactate testing as an extension of point of care ABG's. However, all of our sepsis protocols are built around the assessment of venous lactate. We are starting to see practitioners rely on the arterial lactate rather than the venous lactate and / or reassess an elevated arterial lactate with a venous lactate or vice versa. It is a concern of mine that if a practitioner sees a normal arterial lactate and doesn't assess the venous lactate as well - it could be missed that the venous lactate is elevated (as I understand it, in sepsis the venous lactate will be elevated before the arterial lactate becomes elevated). We have had a couple cases where the practitioner did not activate the sepsis protocols based on a normal arterial lactate, only to find out later the venous lactate was elevated and EGDT was delayed.
I have looked into the research and cannot find much about the use of arterial lactates in sepsis & all the SSC / EGDT studies focus on the use of venous lactate levels. Have any of you ran into this in your sepsis programs and if so, how did you address it? And if anyone out there can point me to research about arterial vs. venous lactate in sepsis? Any thoughts/feedback/suggestions are welcome! Thank you! Stephanie Shawver BSN, RN SLMV Sepsis and Stroke Coordinator St. Luke's Magic Valley 801 Pole Line Road West | Twin Falls, ID 83301 Office: (208) 814.4030 | Email: [email protected]<mailto:[email protected]> Suspect stroke? Think FAST! Facial droop, Arm drift, Speech impairment, Time is brain - this is an emergency! mg.slrmc.org made the following annotations --------------------------------------------------------------------- "This message is intended for the use of the person or entity to which it is addressed and may contain information that is confidential or privileged, the disclosure of which is governed by applicable law. If the reader of this message is not the intended recipient, you are hereby notified that any dissemination, distribution, or copying of this information is strictly prohibited. If you have received this message by error, please notify us immediately and destroy the related message." ---------------------------------------------------------------------
_______________________________________________ Sepsisgroups mailing list [email protected] http://lists.sepsisgroups.org/listinfo.cgi/sepsisgroups-sepsisgroups.org
