ED bedside point-of-care lactate in patients with suspected sepsis is associated with reduced time to iv fluids and mortality

Adam J. Singer, Maria Taylor, Debra LeBlanc, Justin Williams, Henry C. Thode

Research output: Contribution to journalArticle

22 Scopus citations

Abstract

Objective: Early recognition and treatment of sepsis improves outcomes. We determined the effects of bedside point-of-care (POC) lactate measurement on test turnaround time, time to administration of IV fluids and antibiotics, mortality, and ICU admissions in adult ED patients with suspected sepsis. We hypothesized that bedside lactate POC testing would reduce time to IV fluids and antibiotics. Methods: We compared 80 ED patients with suspected sepsis and a lactate level of 2mmol/L or greater before and 80 similar patients after introduction of POC lactate measurements. Groups were compared with ?2 and Mann Whitney U tests. A sample size of 80 patients in each group had 85% power to detect a 30-minute difference in time to IV fluids or antibiotics. Results: Study groups were similar in age, gender, baseline lactate levels, sepsis severity, and Sequential Organ Failure Assessment (SOFA) scores. Introduction of POC lactate was associated with significant reductions in test turnaround time (34 [26-55] vs. 122 [82-149] minutes; P < 0.001), time to IV fluids (55 [34-83] vs. 71 [42-110]minutes; P=0.03), mortality (6% vs. 19%; P=0.02), and ICU admissions (33% vs. 51%, P=0.02), but not time to IV antibiotics (89 [54-156] vs. 88 [60-177] minutes; P = 0.35). Conclusions: Implementation of bedside POC lactate measurement in adult ED patients with suspected sepsis reduces time to test results and time to administration of IV fluids but not antibiotics. A significant reduction in mortality and ICU admissions was also demonstrated, which is likely due, at least in part, to POC testing.

Original languageEnglish (US)
Pages (from-to)1120-1124
Number of pages5
JournalAmerican Journal of Emergency Medicine
Volume32
Issue number9
DOIs
StatePublished - Jan 1 2014

    Fingerprint

ASJC Scopus subject areas

  • Emergency Medicine

Cite this