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. 2016:2016:5765202.
doi: 10.1155/2016/5765202. Epub 2016 Mar 3.

Blood Lactate Is a Useful Indicator for the Medical Emergency Team

Maria Schollin-Borg  1 , Pär Nordin  2 , Henrik Zetterström  3 , Joakim Johansson  4
Affiliations

Blood Lactate Is a Useful Indicator for the Medical Emergency Team

Maria Schollin-Borg et al. Crit Care Res Pract. 2016.

Abstract

Lactate has been thoroughly studied and found useful for stratification of patients with sepsis, in the Intensive Care Unit, and trauma care. However, little is known about lactate as a risk-stratification marker in the Medical Emergency Team- (MET-) call setting. We aimed to determine whether the arterial blood lactate level at the time of a MET-call is associated with increased 30-day mortality. This is an observational study on a prospectively gathered cohort at a regional secondary referral hospital. All MET-calls during the two-year study period were eligible. Beside blood lactate, age and vital signs were registered at the call. Among the 211 calls included, there were 64 deaths (30.3%). Median lactate concentration at the time of the MET-call was 1.82 mmol/L (IQR 1.16-2.7). We found differences between survivors and nonsurvivors for lactate and oxygen saturation, a trend for age, but no significant correlations between mortality and systolic blood pressure, respiratory rate, and heart rate. As compared to normal lactate (<2.44 mmol/L), OR for 30-day mortality was 3.54 (p < 0.0006) for lactate 2.44-5.0 mmol/L and 4.45 (p < 0.0016) for lactate > 5.0 mmol/L. The present results support that immediate measurement of blood lactate in MET call patients is a useful tool in the judgment of illness severity.

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Figures

Figure 1
Figure 1
Enrolment and outcomes of study patients (MET: Medical Emergency Team).
Figure 2
Figure 2
Age (a), lactate (b), respiratory rate (c), saturation (d), systolic blood pressure (e), and pulse (f) in relation to 30-day mortality, n = 211. Square and box indicate median and interquartile range.
Figure 3
Figure 3
30-day mortality for different lactate intervals and levels of pH at Medical Emergency Team calls (n = 211).
See this image and copyright information in PMC

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