But yes, the septic shock criteria references the lactate you identify as 
“initial lactate” in the measure.
If the initial lactate is >4, you would say yes to septic shock.
The one you reference in question 20 “Initial lactate level result”.

From: Sepsisgroups [mailto:[email protected]] On 
Behalf Of Cynthia Wells
Sent: Wednesday, April 05, 2017 8:47 AM
To: Mary Draper
Cc: [email protected]
Subject: [EXTERNAL] Re: [Sepsis Groups] Initial lactate vs repeat lactate result

It depends on which lactate is "drawn" closer to time zero. The lactate used to 
establish time zero is not always the "initial lactate" data element.

Cindy

Sent from my iPhone

On Apr 4, 2017, at 6:20 PM, Mary Draper 
<[email protected]<mailto:[email protected]>> wrote:
I have a patient that met the SIRS criteria with a possible infection though 
etiology unknown and had an initial lactate of 2.2. This ruled the patient in 
for severe sepsis. No hypotension. The repeat lactate 4 hours later is > 4.
Patient is still not hypotensive. Does this then qualify the patient for septic 
shock?
I thought we used the “initial” episode’s lactate not the repeat result.
Appreciate your feedback!
Thanks.


Mary Draper RN BSN
Coordinator Quality Improvement
Peer Review Support CV/CT
Quality Management JMH
Office (925) 674-2045
Cell (925) 451-8792
Fax (925) 674-2373
[email protected]<mailto:[email protected]>
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“O, let us always have a mountain within our soul,  with a peak so high that we 
never quite reach the top…
  For then we will always strive for greater things and will not be content  
with merely climbing hills.”     Ardath Rodale

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