Yes Dana, Lactic acid >2 (or more specifically greater than your lab’s normal reference range) is one criteria for organ failure. For a patient with (simple) sepsis who then has one or more organ failures (elevated lactate being one of them) then qualifies as severe sepsis as well as requires the lactate to be remeasured as part of the six hour bundle (even if central line etc are not required) Lactate > 4 is one criteria for requiring the CVC/CVP Scv02 (and lactate remeasure) . Of note, Lactate > 4 is no longer considered a definition of septic shock – but again, necessitates CVC and attendant measurements
Thanks, Mary Ann Barnes-Daly, RN BSN CCRN DC Regional Clinical Initiative Lead-Sepsis and ICU Liberation (ABCDE) Gordon and Betty Moore Foundation Grant Sutter Health Sacramento- Sierra Region Blackberry: 916.200.5604 Office: 916.614.6370 Assissant: Ruby Dulay 916-614-6362 [email protected] E-mail: [email protected]<mailto:[email protected]> [cid:[email protected]] You never change things by fighting the existing reality. To change something, build a new model that makes the existing model obsolete. R. Buckminster Fuller From: [email protected] [mailto:[email protected]] On Behalf Of DanaMarie Smith Sent: Friday, November 22, 2013 6:10 AM To: [email protected] Subject: [Sepsis Groups] Lactic Acid Im sorry just one more question. For the Lactic Acid, I have been collecting if its >4 as criteria for severe sepsis but I have been seeing articles saying they are considering >2 as criteria for severe sepsis. So I guess my question is do I count Lactic Acid >2 as severe sepsis and the Lactic Acid >4 is for the 6 hr bundle? Thank You, Dana Dana Marie Smith RN Clinical Data Analyst Quality/Performance Improvement Phone # 215- 612-5354 Fax # 215-612-4463
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