Clinical Evaluation of Subcutaneous Lactate Measurement in Patients after Major Cardiac Surgery
Minimally invasive techniques to access subcutaneous adipose tissue for glucose monitoring are successfully applied in type1 diabetic and critically ill patients. During critical illness, the addition of a lactate sensor might enhance prognosis and early intervention. Our objective was to evaluate S...
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| Format: | Article |
| Language: | English |
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Wiley
2009-01-01
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| Series: | International Journal of Endocrinology |
| Online Access: | http://dx.doi.org/10.1155/2009/390975 |
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| author | Martin Ellmerer Martin Haluzik Jan Blaha Jaromir Kremen Stepan Svacina Andreas Plasnik Dimas Ikeoka Manfred Bodenlenz Lukas Schaupp Johannes Plank Thomas R. Pieber |
| author_facet | Martin Ellmerer Martin Haluzik Jan Blaha Jaromir Kremen Stepan Svacina Andreas Plasnik Dimas Ikeoka Manfred Bodenlenz Lukas Schaupp Johannes Plank Thomas R. Pieber |
| author_sort | Martin Ellmerer |
| collection | DOAJ |
| description | Minimally invasive techniques to access subcutaneous adipose tissue for glucose monitoring are successfully applied in type1 diabetic and critically ill patients. During critical illness, the addition of a lactate sensor might enhance prognosis and early intervention. Our objective was to evaluate SAT as a site for lactate measurement in critically ill patients. In 40 patients after major cardiac surgery, arterial blood and SAT microdialysis samples were taken in hourly intervals. Lactate concentrations from SAT were prospectively calibrated to arterial blood. Analysis was based on comparison of absolute lactate concentrations (arterial blood vs. SAT) and on a 6-hour lactate trend analysis, to test whether changes of arterial lactate can be described by SAT lactate. Correlation between lactate readings from arterial blood vs. SAT was highly significant (r2=0.71, P<.001). Nevertheless, 42% of SAT lactate readings and 35% of the SAT lactate trends were not comparable to arterial blood. When a 6-hour stabilization period after catheter insertion was introduced, 5.5% of SAT readings and 41.6% of the SAT lactate trends remained incomparable to arterial blood. In conclusion, replacement of arterial blood lactate measurements by readings from SAT is associated with a substantial shortcoming in clinical predictability in patients after major cardiac surgery. |
| format | Article |
| id | doaj-art-859a69000d3a4d1eb7a5266a741df2a1 |
| institution | Kabale University |
| issn | 1687-8337 1687-8345 |
| language | English |
| publishDate | 2009-01-01 |
| publisher | Wiley |
| record_format | Article |
| series | International Journal of Endocrinology |
| spelling | doaj-art-859a69000d3a4d1eb7a5266a741df2a12025-02-03T07:24:34ZengWileyInternational Journal of Endocrinology1687-83371687-83452009-01-01200910.1155/2009/390975390975Clinical Evaluation of Subcutaneous Lactate Measurement in Patients after Major Cardiac SurgeryMartin Ellmerer0Martin Haluzik1Jan Blaha2Jaromir Kremen3Stepan Svacina4Andreas Plasnik5Dimas Ikeoka6Manfred Bodenlenz7Lukas Schaupp8Johannes Plank9Thomas R. Pieber10Department of Internal Medicine, Medical University Graz, Auenbruggerplatz 15, 8036 Graz, Austria3rd Department of Medicine, 1st Faculty of Medicine, Charles University, Ruská 87, 100 00 Prague, Czech Republic3rd Department of Medicine, 1st Faculty of Medicine, Charles University, Ruská 87, 100 00 Prague, Czech Republic3rd Department of Medicine, 1st Faculty of Medicine, Charles University, Ruská 87, 100 00 Prague, Czech Republic3rd Department of Medicine, 1st Faculty of Medicine, Charles University, Ruská 87, 100 00 Prague, Czech RepublicDepartment of Internal Medicine, Medical University Graz, Auenbruggerplatz 15, 8036 Graz, AustriaDepartment of Internal Medicine, Medical University Graz, Auenbruggerplatz 15, 8036 Graz, AustriaJoanneum Research GmbH, Institute of Medical System Technologies and Health Management, Elisabethstraβe 11a, 8010 Graz, AustriaJoanneum Research GmbH, Institute of Medical System Technologies and Health Management, Elisabethstraβe 11a, 8010 Graz, AustriaDepartment of Internal Medicine, Medical University Graz, Auenbruggerplatz 15, 8036 Graz, AustriaDepartment of Internal Medicine, Medical University Graz, Auenbruggerplatz 15, 8036 Graz, AustriaMinimally invasive techniques to access subcutaneous adipose tissue for glucose monitoring are successfully applied in type1 diabetic and critically ill patients. During critical illness, the addition of a lactate sensor might enhance prognosis and early intervention. Our objective was to evaluate SAT as a site for lactate measurement in critically ill patients. In 40 patients after major cardiac surgery, arterial blood and SAT microdialysis samples were taken in hourly intervals. Lactate concentrations from SAT were prospectively calibrated to arterial blood. Analysis was based on comparison of absolute lactate concentrations (arterial blood vs. SAT) and on a 6-hour lactate trend analysis, to test whether changes of arterial lactate can be described by SAT lactate. Correlation between lactate readings from arterial blood vs. SAT was highly significant (r2=0.71, P<.001). Nevertheless, 42% of SAT lactate readings and 35% of the SAT lactate trends were not comparable to arterial blood. When a 6-hour stabilization period after catheter insertion was introduced, 5.5% of SAT readings and 41.6% of the SAT lactate trends remained incomparable to arterial blood. In conclusion, replacement of arterial blood lactate measurements by readings from SAT is associated with a substantial shortcoming in clinical predictability in patients after major cardiac surgery.http://dx.doi.org/10.1155/2009/390975 |
| spellingShingle | Martin Ellmerer Martin Haluzik Jan Blaha Jaromir Kremen Stepan Svacina Andreas Plasnik Dimas Ikeoka Manfred Bodenlenz Lukas Schaupp Johannes Plank Thomas R. Pieber Clinical Evaluation of Subcutaneous Lactate Measurement in Patients after Major Cardiac Surgery International Journal of Endocrinology |
| title | Clinical Evaluation of Subcutaneous Lactate Measurement in Patients after Major Cardiac Surgery |
| title_full | Clinical Evaluation of Subcutaneous Lactate Measurement in Patients after Major Cardiac Surgery |
| title_fullStr | Clinical Evaluation of Subcutaneous Lactate Measurement in Patients after Major Cardiac Surgery |
| title_full_unstemmed | Clinical Evaluation of Subcutaneous Lactate Measurement in Patients after Major Cardiac Surgery |
| title_short | Clinical Evaluation of Subcutaneous Lactate Measurement in Patients after Major Cardiac Surgery |
| title_sort | clinical evaluation of subcutaneous lactate measurement in patients after major cardiac surgery |
| url | http://dx.doi.org/10.1155/2009/390975 |
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