Correlation of Lactic Acid and Base Deficit Values Obtained From Arterial and Peripheral Venous Samples in a Pediatric Population During Intraoperative Care

Abstract

Lactic acid and base deficit (BD) values are frequently monitored in the intensive care unit and operating room setting to evaluate oxygenation, ventilation, cardiac output, and peripheral perfusion. Although generally obtained from an arterial cannula, such access may not always be available. The current study prospectively investigates the correlation of arterial and peripheral venous values of BD and lactic acid. The study cohort included 48 patients. Arterial BD values ranged from -8 to 4 mEq/L and peripheral venous BD values ranged from -8 to 4 mEq/L. Arterial lactic acid values ranged from 0.36 to 2.45 μmol/L and peripheral venous lactic acid values ranged from 0.38 to 4 μmol/L. The arterial BD (-0.4 ± 2.2 mEq/L) was not significantly different from the peripheral venous BD (-0.6 ± 2.2 mEq/L). The arterial lactic acid (1.0 ± 0.5 μmol/L) was not significantly different from the peripheral venous lactic acid (1.1 ± 0.6 μmol/L). Pearson correlation coefficients demonstrated a very high correlation between arterial and peripheral venous BD ( r = .88, P < .001) and between arterial and peripheral venous lactic acid ( r = .67, P < .001). Bland-Altman plots of both pairs of measures showed that the majority of observations fell within the 95% limits of agreement. Least-squares regression indicated that a 1-unit increase in arterial BD corresponded to a 0.9-unit increase in peripheral venous BD (95% confidence interval [CI]: 0.7-1.0; P < .001) and a 1-unit increase in arterial lactic acid corresponded to a 0.9-unit increase in peripheral venous lactic acid (95% CI: 0.6-1.2; P < .001). These data demonstrate that there is a clinically useful correlation between arterial and peripheral venous lactic acid and BD values.

The Association of Perioperative Serum Lactate Levels with Postoperative Delirium in Elderly Trauma Patients

“…The arterial lactate in many studies was demonstrated to be a biomarker for mortality in critically ill trauma patients [1]. Elevated arterial and venous lactate levels are associated with increased mortality; additionally, some studies have shown strong correlation between these two types of lactate values [27, 28]. Arterial or venous serum lactate level in trauma patients should be measured, because it is an easily obtainable biomarker of physiologic derangements in these patients that might also be used to notify the clinician of a potential increased risk of delirium.…”

The Combination of Lactate Level, Lactate Clearance and APACHE II Score Better Predicts Short-Term Outcomes in Critically Ill Patients: A Retrospective Cohort Study

“…The lactate level is more sensitive and easier to detect to act as an indicator to predict the prognosis of critically ill patients [3]. The imbalance between oxygen delivery and consumption will cause the accumulation of lactate, and lactate levels will rise sharply [4,5]. In addition, hypoperfusion can also result in an increased lactate level.…”

The combination of lactate level, lactate clearance and APACHE II score better predicts short-term outcomes in critically Ill patients: a retrospective cohort study

“…When combining max lactate at T24 with APACHE III, the lactate level is more sensitive and easier to detect and acts as an indicator to predict the prognosis of critically ill patients [3]. The imbalance between oxygen delivery and consumption will cause the accumulation of lactate, and lactate levels will rise sharply [4,5]. In addition, hypoperfusion can also result in an increased lactate level.…”