Lactate measurements in critically ill patients with a hand-held analyser

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Abstract
Objective: To compare a recently introduced hand-held lactate analyser to a reference point of care analyser (POCI) and the hospital laboratory in a critical care setting. Setting: 10-bed surgical/medical intensive care unit in a teaching hospital. Patients and methods: In 39 critically ill patients, 50 convenience measurement cycles consisting of three paired measurements at 30-min intervals were carried out with a hand-held analyser, reference POCI and hospital laboratory using arterial blood samples. Duplicate measurements with the hand-held analyser were done in 129 blood samples. Results: Lactate levels ranged from 1.1 to 21.0 mmol/l. Regression analysis of the hand-held analyser and laboratory showed a slope of 1.01, bias of –0.38 mmol/l, R 2 = 0.97 and mean error of 14.9 %. Reference POCI versus laboratory: slope = 1.07, bias = –0.29 mmol/l, R 2 = 0.98 and mean error of 6.4 %. Hand-held analyser versus reference POCI: slope = 0.90, bias = 0.09 mmol/l and R 2 = 0.92. The hand-held analyser showed acceptable precision. Conclusion: The hand-held lactate analyser can reliably measure arterial blood lactate levels in critically ill patients.

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