Comparison of lactate values obtained from different sites and their clinical significance in patients with severe sepsis
Autor(a) principal: | |
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Data de Publicação: | 2011 |
Outros Autores: | , , , , , |
Tipo de documento: | Artigo |
Idioma: | eng |
Título da fonte: | Repositório Institucional da UNIFESP |
Texto Completo: | http://repositorio.unifesp.br/11600/45550 http://dx.doi.org/10.1590/S1516-31802011000100003 |
Resumo: | CONTEXT AND OBJECTIVE: The ideal site for lactate collection has not been clearly established. This study aimed to evaluate associations between lactate levels in arterial blood (Lart), peripheral venous blood (Lper) and central venous blood (Lean) in patients with severe sepsis or septic shock.DESIGN AND SETTING: Cross-sectional analytical study in an tertiary university hospital.METHOD: Samples from patients with a central venous catheter and from healthy volunteers (control group) were collected. Blood was drawn simultaneously for measurements of Lart, Lper and Lcen, and the first sample was collected less than 24 hours after the onset of organ dysfunction. The results were analyzed using Pearson correlation, Bland-Altman and McNemar tests.RESULTS: A total of 238 samples were collected from 32 patients. The correlation results were r = 0.79 (P < 0.0001) for Lart/Lper and r = 0.84 (P < 0.0001) for Lart/Lcen. Bland-Altman showed large limits of agreement: -3.2 +/- 4.9 (-12.8 to 6.4) and -0.8 +/- 5.9 (-12.5 to 10.8), for Lper and Lcen respectively. lathe control group, there was greater correlation (r = 0.9009, P = 0.0004) and agreement: -0.7 +/- 1.2 (-3.1 to 1.7). Regarding clinical intervention, there was good agreement between Lart/Lcen (96.3%; three disagreements), with worst results for Lart/Lper (87.0%) with 10 cases of disagreement (P = 0.04). In eight patients (80.0%) Lper was higher than Lart.CONCLUSION: Lcen, and not Lper, can replace Lart with good correlation and clinical agreement. Lper tends to overestimate Lart, thus leading to unnecessary therapeutic interventions. |
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Nascente, Ana Paula Metran [UNIFESP]Assunção, Murillo [UNIFESP]Guedes, Carla Janaina [UNIFESP]Freitas, Flavio Geraldo Rezende [UNIFESP]Mazza, Bruno Franco [UNIFESP]Jackiu, Miriam [UNIFESP]Machado, Flavia RibeiroUniversidade Federal de São Paulo (UNIFESP)2018-06-18T11:54:45Z2018-06-18T11:54:45Z2011-01-06Sao Paulo Medical Journal. Sao Paulo: Associacao Paulista Medicina, v. 129, n. 1, p. 11-16, 2011.1516-3180http://repositorio.unifesp.br/11600/45550http://dx.doi.org/10.1590/S1516-31802011000100003S1516-31802011000100003.pdfS1516-3180201100010000310.1590/S1516-31802011000100003WOS:000288620300003CONTEXT AND OBJECTIVE: The ideal site for lactate collection has not been clearly established. This study aimed to evaluate associations between lactate levels in arterial blood (Lart), peripheral venous blood (Lper) and central venous blood (Lean) in patients with severe sepsis or septic shock.DESIGN AND SETTING: Cross-sectional analytical study in an tertiary university hospital.METHOD: Samples from patients with a central venous catheter and from healthy volunteers (control group) were collected. Blood was drawn simultaneously for measurements of Lart, Lper and Lcen, and the first sample was collected less than 24 hours after the onset of organ dysfunction. The results were analyzed using Pearson correlation, Bland-Altman and McNemar tests.RESULTS: A total of 238 samples were collected from 32 patients. The correlation results were r = 0.79 (P < 0.0001) for Lart/Lper and r = 0.84 (P < 0.0001) for Lart/Lcen. Bland-Altman showed large limits of agreement: -3.2 +/- 4.9 (-12.8 to 6.4) and -0.8 +/- 5.9 (-12.5 to 10.8), for Lper and Lcen respectively. lathe control group, there was greater correlation (r = 0.9009, P = 0.0004) and agreement: -0.7 +/- 1.2 (-3.1 to 1.7). Regarding clinical intervention, there was good agreement between Lart/Lcen (96.3%; three disagreements), with worst results for Lart/Lper (87.0%) with 10 cases of disagreement (P = 0.04). In eight patients (80.0%) Lper was higher than Lart.CONCLUSION: Lcen, and not Lper, can replace Lart with good correlation and clinical agreement. Lper tends to overestimate Lart, thus leading to unnecessary therapeutic interventions.Univ Fed Sao Paulo Escola Paulista Med Unifesp EP, Intens Care Unit, Discipline Anesthesiol Pain & Intens Care, Sao Paulo, BrazilUniv Fed Sao Paulo Escola Paulista Med Unifesp EP, Intens Care Unit, Discipline Anesthesiol Pain & Intens Care, Sao Paulo, BrazilWeb of Science11-16engAssociacao Paulista MedicinaSao Paulo Medical JournalLactic acidPerfusionSepsisShock, septicHemodynamicsComparison of lactate values obtained from different sites and their clinical significance in patients with severe sepsisComparação de valores de lactato obtidos em diferentes sítios e sua importância clínica em pacientes com sepse graveinfo:eu-repo/semantics/publishedVersioninfo:eu-repo/semantics/articleinfo:eu-repo/semantics/openAccessreponame:Repositório Institucional da UNIFESPinstname:Universidade Federal de São Paulo (UNIFESP)instacron:UNIFESPORIGINALS1516-31802011000100003.pdfapplication/pdf306906${dspace.ui.url}/bitstream/11600/45550/1/S1516-31802011000100003.pdf55f4064f5aef8d44e0a36d6902e24f40MD51open accessTEXTS1516-31802011000100003.pdf.txtS1516-31802011000100003.pdf.txtExtracted texttext/plain31953${dspace.ui.url}/bitstream/11600/45550/2/S1516-31802011000100003.pdf.txt6e1c35306de1a8908adbdb161b2be1fcMD52open accessTHUMBNAILS1516-31802011000100003.pdf.jpgS1516-31802011000100003.pdf.jpgIM Thumbnailimage/jpeg6582${dspace.ui.url}/bitstream/11600/45550/4/S1516-31802011000100003.pdf.jpg19e254dfb8a69610de832098efb70e2dMD54open access11600/455502022-08-02 12:30:26.081open accessoai:repositorio.unifesp.br:11600/45550Repositório InstitucionalPUBhttp://www.repositorio.unifesp.br/oai/requestopendoar:34652023-05-25T12:12:49.128152Repositório Institucional da UNIFESP - Universidade Federal de São Paulo (UNIFESP)false |
dc.title.en.fl_str_mv |
Comparison of lactate values obtained from different sites and their clinical significance in patients with severe sepsis |
dc.title.alternative.pt.fl_str_mv |
Comparação de valores de lactato obtidos em diferentes sítios e sua importância clínica em pacientes com sepse grave |
title |
Comparison of lactate values obtained from different sites and their clinical significance in patients with severe sepsis |
spellingShingle |
Comparison of lactate values obtained from different sites and their clinical significance in patients with severe sepsis Nascente, Ana Paula Metran [UNIFESP] Lactic acid Perfusion Sepsis Shock, septic Hemodynamics |
title_short |
Comparison of lactate values obtained from different sites and their clinical significance in patients with severe sepsis |
title_full |
Comparison of lactate values obtained from different sites and their clinical significance in patients with severe sepsis |
title_fullStr |
Comparison of lactate values obtained from different sites and their clinical significance in patients with severe sepsis |
title_full_unstemmed |
Comparison of lactate values obtained from different sites and their clinical significance in patients with severe sepsis |
title_sort |
Comparison of lactate values obtained from different sites and their clinical significance in patients with severe sepsis |
author |
Nascente, Ana Paula Metran [UNIFESP] |
author_facet |
Nascente, Ana Paula Metran [UNIFESP] Assunção, Murillo [UNIFESP] Guedes, Carla Janaina [UNIFESP] Freitas, Flavio Geraldo Rezende [UNIFESP] Mazza, Bruno Franco [UNIFESP] Jackiu, Miriam [UNIFESP] Machado, Flavia Ribeiro |
author_role |
author |
author2 |
Assunção, Murillo [UNIFESP] Guedes, Carla Janaina [UNIFESP] Freitas, Flavio Geraldo Rezende [UNIFESP] Mazza, Bruno Franco [UNIFESP] Jackiu, Miriam [UNIFESP] Machado, Flavia Ribeiro |
author2_role |
author author author author author author |
dc.contributor.institution.none.fl_str_mv |
Universidade Federal de São Paulo (UNIFESP) |
dc.contributor.author.fl_str_mv |
Nascente, Ana Paula Metran [UNIFESP] Assunção, Murillo [UNIFESP] Guedes, Carla Janaina [UNIFESP] Freitas, Flavio Geraldo Rezende [UNIFESP] Mazza, Bruno Franco [UNIFESP] Jackiu, Miriam [UNIFESP] Machado, Flavia Ribeiro |
dc.subject.eng.fl_str_mv |
Lactic acid Perfusion Sepsis Shock, septic Hemodynamics |
topic |
Lactic acid Perfusion Sepsis Shock, septic Hemodynamics |
description |
CONTEXT AND OBJECTIVE: The ideal site for lactate collection has not been clearly established. This study aimed to evaluate associations between lactate levels in arterial blood (Lart), peripheral venous blood (Lper) and central venous blood (Lean) in patients with severe sepsis or septic shock.DESIGN AND SETTING: Cross-sectional analytical study in an tertiary university hospital.METHOD: Samples from patients with a central venous catheter and from healthy volunteers (control group) were collected. Blood was drawn simultaneously for measurements of Lart, Lper and Lcen, and the first sample was collected less than 24 hours after the onset of organ dysfunction. The results were analyzed using Pearson correlation, Bland-Altman and McNemar tests.RESULTS: A total of 238 samples were collected from 32 patients. The correlation results were r = 0.79 (P < 0.0001) for Lart/Lper and r = 0.84 (P < 0.0001) for Lart/Lcen. Bland-Altman showed large limits of agreement: -3.2 +/- 4.9 (-12.8 to 6.4) and -0.8 +/- 5.9 (-12.5 to 10.8), for Lper and Lcen respectively. lathe control group, there was greater correlation (r = 0.9009, P = 0.0004) and agreement: -0.7 +/- 1.2 (-3.1 to 1.7). Regarding clinical intervention, there was good agreement between Lart/Lcen (96.3%; three disagreements), with worst results for Lart/Lper (87.0%) with 10 cases of disagreement (P = 0.04). In eight patients (80.0%) Lper was higher than Lart.CONCLUSION: Lcen, and not Lper, can replace Lart with good correlation and clinical agreement. Lper tends to overestimate Lart, thus leading to unnecessary therapeutic interventions. |
publishDate |
2011 |
dc.date.issued.fl_str_mv |
2011-01-06 |
dc.date.accessioned.fl_str_mv |
2018-06-18T11:54:45Z |
dc.date.available.fl_str_mv |
2018-06-18T11:54:45Z |
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info:eu-repo/semantics/publishedVersion |
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info:eu-repo/semantics/article |
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article |
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publishedVersion |
dc.identifier.citation.fl_str_mv |
Sao Paulo Medical Journal. Sao Paulo: Associacao Paulista Medicina, v. 129, n. 1, p. 11-16, 2011. |
dc.identifier.uri.fl_str_mv |
http://repositorio.unifesp.br/11600/45550 http://dx.doi.org/10.1590/S1516-31802011000100003 |
dc.identifier.issn.none.fl_str_mv |
1516-3180 |
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S1516-31802011000100003.pdf |
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S1516-31802011000100003 |
dc.identifier.doi.none.fl_str_mv |
10.1590/S1516-31802011000100003 |
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WOS:000288620300003 |
identifier_str_mv |
Sao Paulo Medical Journal. Sao Paulo: Associacao Paulista Medicina, v. 129, n. 1, p. 11-16, 2011. 1516-3180 S1516-31802011000100003.pdf S1516-31802011000100003 10.1590/S1516-31802011000100003 WOS:000288620300003 |
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http://repositorio.unifesp.br/11600/45550 http://dx.doi.org/10.1590/S1516-31802011000100003 |
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eng |
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Sao Paulo Medical Journal |
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11-16 |
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Associacao Paulista Medicina |
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Associacao Paulista Medicina |
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