SynthesisScandinavian journal of trauma, resuscitation and emergency medicine2024
The use and impact of prehospital blood lactate measurements in acute non-traumatic patients: a systematic review.
Synthesis in Scandinavian journal of trauma, resuscitation and emergency medicine, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers, 1 of them a synthesis that pooled it.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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Who cites it
2 citing papers in PubMed, 1 synthesis or guideline pooled it.
- The use and impact of prehospital blood lactate measurements in acute non-traumatic patients: a systematic review.Scandinavian journal of trauma, resuscitation and emergency medicine · 2024Pooled it
- Prehospital lactate, transfer time, and early mortality across emergency diagnostic categories.Critical care (London, England) · 2026Observational
Corrections and comments
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Authors and funding
7 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundThe prehospital use of blood lactate measurements is increasing. However, the test's benefits have not been methodically evaluated in non-trauma patients. This study had three aims: (1) To assess the evidence of prehospital blood lactate measurements' prognostic value in non-trauma patients, (2) to investigate to what extent the test changed early patient treatment, and (3) to evaluate the healthcare personnel's attitude towards the test.
methodsMEDLINE, Embase, and Cochrane Central Register of Controlled Trials were systematically searched until Aug 26, 2023. Cohort and randomized controlled trials assessing ≥ 20 acute non-trauma patients with prehospital lactate measurements were included if they reported (1) prognostic outcomes such as short-term mortality or (2) changes in early patient treatments. All study designs were included to assess (3) the healthcare personnel's opinion on prehospital lactate measurements. The risks of bias were assessed using the QUIPS tool, the Newcastle-Ottawa Scale, and the RoB-2. Study registration number CRD42020167169 (PROSPERO).
resultsWe screened 6028 study reports. We included 15 studies on (1) the prognostic value of prehospital lactate measurements. Elevated blood lactate levels were correlated to a higher short-term mortality risk in most of the studies but not in studies with out-of-hospital cardiac arrest (OHCA) patients. The 15 prognostic studies were all cohort studies with moderate or high risks of bias. Four studies investigated (2) early treatment changes. They found that the prehospital lactate measurement may have changed early treatment in sepsis patients. However, all four studies on treatment changes were at high risk of bias. Four studies were included on (3) the healthcare personnel's attitude towards the lactate measurement. Evidence of the healthcare personnel's opinion on prehospital lactate measurements was scarce.
conclusionMost acute non-trauma patients with elevated prehospital lactate levels had increased risks of short-term mortality, except OHCA patients. Few studies suggested that measuring prehospital lactate levels could change early patient care, particularly in patients with suspected sepsis. The certainty of the evidence is low in this systematic review. The included studies were heterogeneous, and many had high risks of bias. Further studies are needed to investigate the impact of prehospital lactate measurements on patient care.
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