Observational studyThe journal of trauma and acute care surgery2015
A comparison of prehospital lactate and systolic blood pressure for predicting the need for resuscitative care in trauma transported by ground.
Observational study in The journal of trauma and acute care surgery, 2015. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 25 papers, 2 of them syntheses that pooled it.
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Who cites it
25 citing papers in PubMed, 2 syntheses or guidelines pooled it.
- Criteria for trauma team activation and staffing requirements for the management of patients with (suspected) multiple and/or severe injuries in the resuscitation room- a systematic review and clinical practice guideline update.European journal of trauma and emergency surgery : official publication of the European Trauma Society · 2025Pooled it
- The potential of point-of-care diagnostics to optimise prehospital trauma triage: a systematic review of literature.European journal of trauma and emergency surgery : official publication of the European Trauma Society · 2023Pooled it
- Diagnostic value of prehospital arterial blood gas measurements - a randomised controlled trial.Scandinavian journal of trauma, resuscitation and emergency medicine · 2019Trial
- Serial Lactate in Clinical Medicine - A Narrative Review.Journal of intensive care medicine · 2026Review
- Review
- Observational Analysis of Point-of-Care Lactate Plus™ Meter in Preclinical Trauma Models.Diagnostics (Basel, Switzerland) · 2024Article
- Identifying trigger cues for hospital blood transfusions based on ensemble of machine learning methods.International journal of emergency medicine · 2024Article
- The predictive value of serum lactate to forecast injury severity in trauma-patients increases taking age into account.European journal of trauma and emergency surgery : official publication of the European Trauma Society · 2024Article
- Identifying Trigger Cues for Hospital Blood Transfusions Based on Ensemble Learning Methods.Research square · 2024Article
- Early correction of base deficit decreases late mortality in polytrauma.European journal of trauma and emergency surgery : official publication of the European Trauma Society · 2024Article
- Predictive clinical utility of pre-hospital point of care lactate for transfusion of blood product in patients with suspected traumatic haemorrhage: derivation of a decision-support tool.Scandinavian journal of trauma, resuscitation and emergency medicine · 2022Article
- Elevated serum lactate levels and age are associated with an increased risk for severe injury in trauma team activation due to trauma mechanism.European journal of trauma and emergency surgery : official publication of the European Trauma Society · 2022Article
- Pre-hospital suPAR, lactate and CRP measurements for decision-making: a prospective, observational study of patients presenting non-specific complaints.Scandinavian journal of trauma, resuscitation and emergency medicine · 2021Observational
- Lactate levels and clearance rate in neonates undergoing mechanical ventilation in Tibet.The Journal of international medical research · 2020Article
- Validation of a point-of-care capillary lactate measuring device (Lactate Pro 2).Scandinavian journal of trauma, resuscitation and emergency medicine · 2020Observational
- Determinants of prehospital lactate in trauma patients: a retrospective cohort study.BMC emergency medicine · 2020Article
- Prehospital lactate improves prediction of the need for immediate interventions for hemorrhage after trauma.Scientific reports · 2019Article
- Diagnosis and management of metabolic acidosis: guidelines from a French expert panel.Annals of intensive care · 2019Review
- Prehospital Lactate Predicts Need for Resuscitative Care in Non-hypotensive Trauma Patients.The western journal of emergency medicine · 2018Article
- Research questions in pre-hospital trauma care.PLoS medicine · 2017Article
Corrections and comments
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Authors and funding
15 authors.
Funding
Abstract
backgroundReliance on prehospital trauma triage guidelines misses patients with serious injury. Lactate is a biomarker capable of identifying high-risk trauma patients. Our objective was to compare prehospital point-of-care lactate (P-LAC) with systolic blood pressure (SBP) for predicting the need for resuscitative care (RC) in trauma patients transported by ground emergency medical services.
methodsThis is a prospective observational study at nine sites within the Resuscitation Outcomes Consortium conducted from March 2011 to August 2012. Lactate was measured on patients with a prehospital SBP of 100 mm Hg or less who were transported by emergency medical services to a Level I or II trauma center. Patients were followed up for the need for RC, defined as any of the following within 6 hours of emergency department arrival: blood transfusion of 5 U or greater; intervention for hemorrhage including thoracotomy, laparotomy, pelvic fixation, or interventional radiology embolization; or death.
resultsA total of 387 patients had a lactate value and presented with SBP between 71 mm Hg and 100 mm Hg, and 70 (18%) required RC. With the use of a P-LAC decision rule (≥2.5 mmol/L) that yielded the same specificity as that of SBP of 90 mm Hg or less (48%), the observed sensitivities for RC were 93% (95% confidence interval [CI], 84-98%) for P-LAC of 2.5 mmol/L or greater and 67% (95% CI, 55-78%) for SBP of 90 mm Hg or less (McNemar's test, p < 0.001). P-LAC has an estimated area under the curve of 0.78 (95% CI, 0.73-0.83), which is statistically superior to that of SBP (0.59; 95% CI, 0.53-0.66) and shock index (heart rate / SBP) (0.66; 95% CI, 0.60-0.74).
conclusionP-LAC obtained at the scene is associated with the need for RC. P-LAC is superior to other early surrogates for hypoperfusion (SBP and shock index) in predicting the need for RC in trauma patients with 70 mm Hg < SBP ≤ 100 mm Hg. LEVEL OF EVIDENCE: Prognostic study, level II.
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