Hip Fractures Clinical Trial
Official title:
Optimal Blood Sampling Site for Point of Care Lactate Assessment
The study was to compare blood Lactate levels between ear lobe and finger against venous forearm blood sample using the electronic hand held lactate device in hip fracture patients with good cognitive function (AMT >/= 7)
Following a hip fracture, surgical treatment is advocated to improve pain and mobility. Most
patients are elderly and a majority of them are frail. Current best practice tariff and
National Institute for health and care excellence guidelines recommends that all those
patients who undergo an operation should be performed within 36 hours from the time of injury
to optimise recovery and function. The patients need to be medically optimised to undergo a
major operation to have their hip fracture fixed. The adequacy of resuscitation is monitored
by several clinical and biochemical markers. One of the important markers of resuscitation is
serum lactate levels. This is used routinely in polytrauma patients. (Moran and Forward,
2012) The initial interest in lactate in hip fracture patients was based on the philosophy
that a hip fracture in a frail elderly patient may be equivalent to a polytrauma in a young
fit patient. Subsequently, high serum lactate levels on admission in hip fracture patients
have been shown to be associated with higher mortality1. However, at present, this is not
routinely monitored in hip fracture patients. Measurement of serum lactate levels presents
logistics difficulties, as the blood sample has to be taken to an analyser and analysed
within 20 minutes. Hence the investigators want to use a point of care electronic hand held
device - the Lactate Pro 2. The investigators have already tested this device against the
laboratory analysers and it has been proven to be accurate. However in preliminary testing
the investigators found a significant difference between fingertip and earlobe samples in
volunteers. The volunteers do not represent our population of interest, which are hip
fracture patients. The investigators aim is to determine which sample site; earlobe or
fingertip, for Lactate Pro 2 testing best matches venous forearm samples upon which the
association of higher mortality with high lactate was based.
Any risk to the patients participating in this study would be very small. The inclusion
criteria to participate in this research study is a patient who has had a recent hip fracture
awaiting surgery with a Mental Test score of 7/10 or above and is able to consent.
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