The handheld blood lactate analyser versus the blood gas based analyser for measurement of serum lactate and its prognostic significance in severe sepsis

Abstract

BackgroundThis study was done to compare the accuracy of the Lactate Pro LT 1710 (Arkray Inc., Kyoto, Japan) with the Combiline Plus (Eschweiler GmbH & Co. KG Holzkoppelweg, Kiel, Germany), and also, to analyze the prognostic significance of serum lactates and Simplified Acute Physiology Score 3 (SAPS 3) in patients of severe sepsis. Methods106 patients of severe sepsis admitted to the ICU were screened. The serum lactate from an arterial sample analyzed in both the machines was recorded at admission and at 48h. These patients were then followed up to the 28th day for mortality. ResultsThe Lactate Pro LT 1710 handheld point of care lactate meter provides consistent results comparable to the Eschweiler Combiline blood gas analyser. Serum lactate concentration was significantly higher in nonsurvivors at the time of admission (3.30±1.26) and at 48h (4.34±1.73). Lactate clearance at 48h appears to be a better predictor of mortality than the lactate levels at 0h and 48h. The mean SAPS 3 at admission amongst survivors was significantly less as compared to nonsurvivors. The SAPS 3 had improved to 47.44 (±11.79) in survivors at 48h, while in nonsurvivors it had worsened to 81.98 (±12.32) (p=0.00); thus, a worsening SAPS 3 at 48h had a poorer prognosis. ConclusionsThe Lactate Pro LT 1710 provides similar results to the Combiline Eschweiler blood gas analyser and is a cheaper alternative. It would prove to be a boon in peripheral hospitals in the aggressive management of critically ill patients.