Lactate measurements in critically ill patients with a hand-held analyser

Objective: To compare a recently introduced hand-held lactate analyser to a reference point of care analyser (POCI) and the hospital laboratory in a c ritical care setting. Setting: 10-bed surgical/medical intensive care unit in a teaching hospital . Patients and methods: In 39 critically ill patients, 50 convenience measure ment cycles consisting of three paired measurements at 30-min intervals wer e carried out with a hand-held analyser, reference POCI and hospital labora tory using arterial blood samples. Duplicate measurements with the hand-hel d analyser were done in 129 blood samples. Results: Lactate levels ranged from 1.1 to 21.0 mmol/l, Regression analysis of the hand-held analyser and laboratory showed a slope of 1.01, bias of - 0.38 mmol/l, R-2 = 0.97 and mean error of 14.9 %. Reference POCI versus lab oratory: slope = 1.07, bias = -0.29 mmol/l, R-2 = 0.98 and mean error of 6. 4 %. Hand-held analyser versus reference POCI: slope = 0.90, bias = 0.09 mm ol/l and R-2 = 0.92. The hand-held analyser showed acceptable precision. Conclusion: The hand-held lactate analyser can reliably measure arterial bl ood lactate levels in critically ill patients.