Agreement Between Arterial, Central Venous, and Peripheral Venous Lactate in the Intensive Care Unit

Blood Lactate Analysis Clinical Trial

Official title:

Agreement Between Arterial, Central Venous, and Peripheral Venous Lactate in the Intensive Care Unit

Clinical Trial Details — Status: Not yet recruiting

Administrative data

• NCT number: NCT01624519
• Other study ID #: 10H-821002
• Status: Not yet recruiting
• Phase: N/A
• First received: June 18, 2012
• Last updated: June 18, 2012
• Start date: August 2012
• Est. completion date: August 2013

Study information

• Verified date: June 2012
• Source: University of California, Los Angeles
• Contact: Richard Treger, MD
• Email: Rick.Treger[@]gmail.com
• Is FDA regulated: No
• Health authority: United States: Institutional Review Board
• Study type: Interventional

Clinical Trial Summary

The main objective of this study is to examine the agreement between arterial, central venous, and peripheral venous lactate values in a population of medical Intensive Care Unit (ICU) patients.

Description:

This study is a single-center, prospective trial to assess the agreement between arterial, central venous, and peripheral venous lactate measurements. When an arterial lactate is deemed to be necessary as part of ICU management, a central venous and peripheral venous sample will also obtained within 5 minutes. All of the samples will be analyzed using the same analyzer as quickly as possible. A maximum of 10 paired arterial and venous lactate samples will be obtained per patient to prevent a single patient from dominating the data set. Additional data collected on a standardized data collection form will include primary diagnosis, intubation status, use of inotropic agents, hypotension (defined as a systolic blood pressure < 90 mm Hg), ICU length of stay and mortality. The Bland-Altman method will be used to assess agreement between arterial (A), central venous(CV), and peripheral venous (PV) lactate measurements. Approximately 50 patients will be enrolled in this study.

Recruitment information / eligibility

• Status: Not yet recruiting
• Enrollment: 50
• Est. completion date: August 2013
• Est. primary completion date: August 2013
• Accepts healthy volunteers: No
• Gender: Both
• Age group: 18 Years and older

Eligibility

Inclusion Criteria:

• Adult patients 18 years or older

• Admitted to the Intensive Care Unit (ICU)

• Determined by their treating clinicians to require both a central venous line and arterial line

Exclusion Criteria:

Study Design

Intervention Model: Single Group Assignment, Masking: Open Label, Primary Purpose: Diagnostic

Related Conditions & MeSH terms

• Blood Lactate Analysis

Intervention

Procedure:
• Blood Lactate Analysis
When an arterial lactate is deemed to be necessary as part of ICU management, a central venous and peripheral venous sample will also obtained within 5 minutes. All of the samples will be analyzed using the same analyzer as quickly as possible.

Locations

Country	Name	City	State
n/a

Sponsors (2)

Lead Sponsor	Collaborator
University of California, Los Angeles	Olive View-UCLA Education & Research Institute

References & Publications (14)

Adams J 2nd, Hazard P. Comparison of blood lactate concentrations in arterial and peripheral venous blood. Crit Care Med. 1988 Sep;16(9):913-4. — View Citation

BRODER G, WEIL MH. EXCESS LACTATE: AN INDEX OF REVERSIBILITY OF SHOCK IN HUMAN PATIENTS. Science. 1964 Mar 27;143(3613):1457-9. — View Citation

Cowan BN, Burns HJ, Boyle P, Ledingham IM. The relative prognostic value of lactate and haemodynamic measurements in early shock. Anaesthesia. 1984 Aug;39(8):750-5. — View Citation

Criscuolo C, Nepper G, Buchalter S. Reflex sympathetic dystrophy following arterial blood gas sampling in the intensive care setting. Chest. 1995 Aug;108(2):578-80. Review. — View Citation

Domino EF, Bartolini A, Kawamura H. Effects of reticular stimulation, d-amphetamine and scopolamine on acetylcholine release from the hippocampus of brainstem transected cats. Arch Int Pharmacodyn Ther. 1977 Feb;225(2):294-302. — View Citation

Gallagher EJ, Rodriguez K, Touger M. Agreement between peripheral venous and arterial lactate levels. Ann Emerg Med. 1997 Apr;29(4):479-83. — View Citation

Klein WW, Brandt D, Kraft-Kinz J, Schreyer H. [Dynamics and metabolism in coronary heart disease before and after revascularization intervention]. Acta Med Austriaca. 1976;3(3):69-73. German. — View Citation

Middleton P, Kelly AM, Brown J, Robertson M. Agreement between arterial and central venous values for pH, bicarbonate, base excess, and lactate. Emerg Med J. 2006 Aug;23(8):622-4. — View Citation

Mizock BA. Controversies in lactic acidosis. Implications in critically ill patients. JAMA. 1987 Jul 24-31;258(4):497-501. — View Citation

Mortensen JD. Clinical sequelae from arterial needle puncture, cannulation, and incision. Circulation. 1967 Jun;35(6):1118-23. — View Citation

Murdoch IA, Turner C, Dalton RN. Arterial or mixed venous lactate measurement in critically ill children. Is there a difference? Acta Paediatr. 1994 Apr;83(4):412-3. — View Citation

Rivers E, Nguyen B, Havstad S, Ressler J, Muzzin A, Knoblich B, Peterson E, Tomlanovich M; Early Goal-Directed Therapy Collaborative Group. Early goal-directed therapy in the treatment of severe sepsis and septic shock. N Engl J Med. 2001 Nov 8;345(19):1368-77. — View Citation

Weil MH, Michaels S, Rackow EC. Comparison of blood lactate concentrations in central venous, pulmonary artery, and arterial blood. Crit Care Med. 1987 May;15(5):489-90. — View Citation

Younger JG, Falk JL, Rothrock SG. Relationship between arterial and peripheral venous lactate levels. Acad Emerg Med. 1996 Jul;3(7):730-4. — View Citation

* Note: There are 14 references in all — Click here to view all references

Outcome

Type	Measure	Description	Time frame	Safety issue
Primary	Agreement between peripheral venous, central venous, and arterial lactate values in a population of medical Intensive Care Unit (ICU) patients.		1 year	No