Method of Lavery et al for Using Venous Lactate Concentrations in the Triage of a Trauma Patient

 

The advantage of the venous lactate measurement is that it does not require an arterial sample.

 

estimated arterial lactate concentration in mmol/L =

= (0.889 * (venous lactate concentration in mmol/L)) + 0.076

 

A venous lactate concentration >= 2.0 mmol/L:

(1) correlates with an ISS >= 13

(2) the need for ICU care

(3) increased mortality

Venous Lactate	Mortality Rate
0 mmol/L	4%
2.5 mmol/L	6%
5.0 mmol/L	12%
7.5 mmol/L	21%
10.0 mmol/L	38%
12.5 mmol/L	55%
15.0 mmol/L	71%
17.5 mmol/L	84%

from Figure 4, page 662

 

If this data is analyzed in JMP:

 

percent mortality =

= (-0.018909 * ((venous lactate)^3)) + (0.6839827 * ((venous lactate)^2)) - (1.62381 * (venous lactate)) + 4.72727

 

Performance:

• Triage worked best for patients with blunt trauma in motor vehicle accidents.

 

Limitations:

• A small injury may not be associated with a significant rise in lactate early, resulting in a false negative result.

• The specimen needs to be collected, transported and tested properly to give valid results.