Article on arterial v. venous lactate: Younger JG, Falk JL, Rothrock SG. Relationship between arterial and peripheral venous lactate levels. Acad Emerg Med 1996; 3:730–734.
A better test is: [arterial - venous] pH Michael Ries MD, MBA, FCCM, FCCP, FACP Medical Director, Adult Critical Care and eICU Advocate Health Care [email protected] Tel: 630-575-8364 Tel: 773-935-5556 Fax: 312-573-1837 Cell: 312-613-0031 Pager: 773-935-5556 This e-mail, and any attachments thereto, is intended only for use by the addressee(s) named herein and may contain legally privileged and/or confidential information. If you are not the intended recipient of this e-mail (or the person responsible for delivering this document to the intended recipient), you are hereby notified that any dissemination, distribution, printing or copying of this e-mail, and any attachments thereto, is strictly prohibited. If you have received this e-mail in error, please respond to the individual sending the message and permanently delete the original and any copy of any e-mail and any printout thereof. -----Original Message----- From: Shawver, Stephanie <[email protected]> To: sepsisgroups <[email protected]> Sent: Mon, Nov 12, 2012 2:45 pm Subject: [Sepsis Groups] Venous vs. Arterial Lactate Colleagues, Our facility has recently implemented point of care arteriallactate testing as an extension of point of care ABG’s. However, all ofour sepsis protocols are built around the assessment of venous lactate. We arestarting to see practitioners rely on the arterial lactate rather than thevenous lactate and / or reassess an elevated arterial lactate with a venouslactate or vice versa. It is a concern of mine that if a practitioner sees anormal 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, insepsis the venous lactate will be elevated before the arterial lactate becomeselevated). We have had a couple cases where the practitioner did not activatethe sepsis protocols based on a normal arterial lactate, only to find out laterthe venous lactate was elevated and EGDT was delayed. I have looked into the research and cannot find much about theuse of arterial lactates in sepsis & all the SSC / EGDT studies focus onthe use of venous lactate levels. Have any of you ran into this in your sepsisprograms and if so, how did you address it? And if anyone out there can pointme to research about arterial vs. venous lactate in sepsis? Anythoughts/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] Suspect stroke? Think FAST! Facial droop, Arm drift, Speechimpairment, 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
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