Nichol et al used the time-averaged concentration for serum lactate over 24 hours to monitor critically ill patients. The authors are from Monash University, University of Melbourne, multiple hospitals in Melbourne, Australia, and Okayama University Hospital in Japan.
Patient selection: patient in the ICU
Measurements: several measurements of the serum lactate concentration over 24 hours
area for 2 sequential readings =
= ((concentration at T1) + (concentration at T2)) / 2 * (hours between the 2 specimens)
time-weighted average over 24 hours in mmol/L =
= SUM(areas for sequential readings over 24 hours) / 24
Both hospital and ICU mortalities increase as the time-weighted average for the first 24 hours in the ICU increases.
Time Weight Average
Odds Ratio for ICU Mortality
0.99 to 1.32 mmol/L
2.0
1.32 to 1.72 mmol/L
3.0
1.72 to 2.50 mmol/L
5.0
> 2.50 mmol/L
9.0
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