Hi folks, It has been our understanding that, for all intents and purposes, venous and arterial lactate levels can be used interchangeably and that the *trend* is the important point.
In a really quick look online to illustrate, I came across these... http://www.ncbi.nlm.nih.gov/pubmed/22745117: RESULTS: Six hundred seventy-three Lact(cv)/Lact(a) pairs in 188 patients were analyzed. AUC of Lact(cv) to predict a Lact(a) above 2 and 4 mmol/L was 0.98 (95% confidence interval: 0.97-0.99) and 0.98 (95% confidence interval: 0.96-0.99), respectively. Lact(cv) with the cutoff value of 2 mmol/L can predict a Lact(a) above 2 mmol/L with sensitivity >92% and specificity >90%. AUC for Lact(cv) clearance to detect a Lact(a) clearance <10% or >10% was 0.93 or 0.94, respectively. CONCLUSION: Lact(cv) and Lact(a) collected within a 30-minute range are interchangeable for clinical practice. http://onlinelibrary.wiley.com/doi/10.1111/j.1553-2712.1996.tb03502.x/epdf "Even in patients with the highest lactate concentrations, the arterial-venous discrepancy was relatively small, and probably of little clinical import." Would be interested to see what others are doing/thinking about this with rationale.... Sam -- Sam Farrell, RN CCRN Intensivist Program Manager West Coast Critical Care Specialists office: 805.988.7004 fax: 805.988.7101 cell: 805.444.3730 wccriticalcare.com *CONFIDENTIALITY NOTICE : This message and any included attachments are intended only for the addressee and may contain confidential information belonging to the sender that is legally protected. Unauthorized forwarding, printing, copying, distribution, or use of such information is strictly prohibited and may be unlawful. If you are not the addressee, please promptly delete this message and notify the sender of the delivery error by e-mail. Thank you.* On Thu, Jan 14, 2016 at 2:22 PM, Carter, Anne <[email protected]> wrote: > As long as ALL future lactic acids are drawn arterially; you cant mix and > match. Once arterial always arterial. > > > > *Anne Carter MS, ACNS-BC, CEN* > > *Coordinator* > > *Outcomes Management* > > *Riverview Medical Center* > > *732-450-2735 <732-450-2735>* > > *[email protected] <[email protected]>* > > > > > > “This document and the information attached is Patient Safety Work Product > & as such, is privileged and confidential pursuant to the N.J. Patient > Safety Act and the Federal Patient Safety & Quality Improvement Act of 2005 > and should not be further disclosed except as permitted by law.” > > > > > > > > *From:* Sepsisgroups [mailto:[email protected]] *On > Behalf Of *Andre Vovan > *Sent:* Tuesday, January 12, 2016 6:18 PM > *To:* Gerolamo, Jeannine <[email protected]> > *Cc:* [email protected] > *Subject:* Re: [Sepsis Groups] Arterial line versus venous draw > > > > "Note, this is an external email and did not originate at Meridian Health”. > ------------------------------ > > Venous or arterial line samples are both good. > > > Andre Vovan, MD, MBA > President/CEO > Newport Critical Care, Inc > > > > On Fri, Jan 8, 2016 at 10:42 AM, Gerolamo, Jeannine < > [email protected]> wrote: > > Are lactic acids drawn from an arterial line acceptable? > > > > *Jeannine Gerolamo (Fahy), MSN, BS, RN* > > Safety/Quality Specialist > > > > The Center for Patient Safety and Healthcare Quality > > 215-481-4334 (Office) > > 215-481-3510 (Fax) > > [email protected] > > [image: Description: Description: Description: A-J-LogoEmailSig] > <https://urldefense.proofpoint.com/v2/url?u=http-3A__www.abingtonhealth.org_&d=CwMFaQ&c=lC2BOuyTwLhYUwx2vqZp6A4NC8GJH--j-GtKaBDeEwM&r=M-Lm1W7boN5wHPqoUXvlmN-X-MbpoIB7ZVxYyg6jVBo&m=XwqwtdWtRjPU8p-5GBiiNagkZTHNJoLqaOhzkcoTCO4&s=pbT90NgnVSy1YZrFow83XqSWNlmgZMSndI0nbfhMirM&e=> > > [image: Description: Description: Description: facebook] > <https://urldefense.proofpoint.com/v2/url?u=http-3A__www.facebook.com_AbingtonHealth&d=CwMFaQ&c=lC2BOuyTwLhYUwx2vqZp6A4NC8GJH--j-GtKaBDeEwM&r=M-Lm1W7boN5wHPqoUXvlmN-X-MbpoIB7ZVxYyg6jVBo&m=XwqwtdWtRjPU8p-5GBiiNagkZTHNJoLqaOhzkcoTCO4&s=jYOC71AyFp28sWwt_H75fzI0u3cQ6LwW21D3KFkRieo&e=>[image: > Description: Description: Description: twitter] > <https://urldefense.proofpoint.com/v2/url?u=http-3A__twitter.com_AbingtonHealth&d=CwMFaQ&c=lC2BOuyTwLhYUwx2vqZp6A4NC8GJH--j-GtKaBDeEwM&r=M-Lm1W7boN5wHPqoUXvlmN-X-MbpoIB7ZVxYyg6jVBo&m=XwqwtdWtRjPU8p-5GBiiNagkZTHNJoLqaOhzkcoTCO4&s=PBIOlH2EL6Og98YriU1zt9Bkjlzc1Udy7MkVtLioqTk&e=>[image: > Description: Description: Description: youtube] > <https://urldefense.proofpoint.com/v2/url?u=http-3A__www.youtube.com_AbingtonHealth&d=CwMFaQ&c=lC2BOuyTwLhYUwx2vqZp6A4NC8GJH--j-GtKaBDeEwM&r=M-Lm1W7boN5wHPqoUXvlmN-X-MbpoIB7ZVxYyg6jVBo&m=XwqwtdWtRjPU8p-5GBiiNagkZTHNJoLqaOhzkcoTCO4&s=WY6sj7MixSgmtOxx9iNMDhyAL4dnog9TkBbzPNUxZkQ&e=>[image: > Description: Description: Description: instagram] > <https://urldefense.proofpoint.com/v2/url?u=http-3A__instagram.com_AbingtonHealth_&d=CwMFaQ&c=lC2BOuyTwLhYUwx2vqZp6A4NC8GJH--j-GtKaBDeEwM&r=M-Lm1W7boN5wHPqoUXvlmN-X-MbpoIB7ZVxYyg6jVBo&m=XwqwtdWtRjPU8p-5GBiiNagkZTHNJoLqaOhzkcoTCO4&s=dewJSH5DEYYlTa_n2hPlIiC0R546eeJBuC-_fGvZ-WQ&e=> > > > > > ------------------------------ > > > ****************** CONFIDENTIALITY NOTICE ********************** > > This e-mail contains LEGALLY PRIVILEGED AND CONFIDENTIAL INFORMATION > intended only for the use of the recipient named above. 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