PT - JOURNAL ARTICLE AU - Kay Choong See AU - Joy Dizon AU - Malcolm Mahadevan AU - Tow Keang Lim AU - Jason Phua TI - Impact of point-of-care lactate measurement on mortality in critically-ill patients requiring mechanical ventilation DP - 2014 Sep 01 TA - European Respiratory Journal PG - P2062 VI - 44 IP - Suppl 58 4099 - http://erj.ersjournals.com/content/44/Suppl_58/P2062.short 4100 - http://erj.ersjournals.com/content/44/Suppl_58/P2062.full SO - Eur Respir J2014 Sep 01; 44 AB - Background. Lactate levels correlate with mortality and can guide the resuscitation of patients with severe sepsis. However, the wider impact of early, point-of-care lactate measurement (POC-Lac) in the emergency department (ED) for both septic and non-septic patients who require mechanical ventilation is unclear. We investigated the clinical outcomes of these patients who received POC-Lac in ED, compared to patients who did not.Methods. Observational study of mechanically-ventilated patients admitted to a 20-bed medical intensive care unit (ICU) of a 1081-bed university hospital in 2010-2012. Resuscitation bundles according to the Surviving Sepsis Campaign guidelines were in place, though no equivalent protocols existed for non-septic conditions. Analyses for ICU and hospital mortality were controlled for sepsis diagnosis and other confounders.Results. We studied 1,430 patients (age 61.2 ± 16.5 years, 39.7% female, 43.4% diagnosed with sepsis at ED, 26.6% ICU mortality, 32.5% hospital mortality). 609 patients (42.6%) had POC-Lac in the ED. POC-Lac was significantly associated with lower GCS score, systolic blood pressure and PaO2/FIO2 ratio. POC-Lac was also significantly associated with more therapy instituted in ED (intubation, vasopressors, antibiotics), more direct ED-to-ICU transfers, and decreased ICU (adjusted OR 0.64, 95% CI 0.48-0.88, P=0.005) and hospital mortality (adjusted OR 0.71, 95% CI 0.55-0.90, P=0.006).Conclusions. Early, POC-Lac in ED was associated with earlier intensive therapy and improved survival in critically-ill patients requiring mechanical ventilation.