Jones Alan E, Leonard Matthew M, Hernandez-Nino Jackeline, Kline Jeffrey A
Department of Emergency Medicine, Carolinas Medical Center, Charlotte, NC, USA.
Acad Emerg Med. 2007 Jul;14(7):587-91. doi: 10.1197/j.aem.2007.03.1351. Epub 2007 May 18.
The authors sought to determine the effect of in vitro time, temperature, and removable tourniquet use on changes in venous point-of-care lactate concentrations.
This was a prospective randomized trial on healthy volunteers. Subjects were randomized to one of three groups: group 1 had venous lactate concentrations measured on blood drawn without a tourniquet and the sample placed in ice (-1 degrees C), group 2 had lactate concentrations measured on blood drawn without a tourniquet and the sample left at 23 degrees C, and group 3 had lactate concentrations measured on blood drawn with a tourniquet placed 5 minutes before venipuncture and the sample placed in ice (-1 degrees C). Lactate concentrations were measured on a point-of-care device at time 0, 3, 6, 9, 12, and 15 minutes in all three groups. Mean lactate concentrations were analyzed using a two-way repeated-measures analysis of variance.
Eighty subjects were randomized, with complete data available in 63 (21 per group). Over the 15-minute period, lactate concentrations increased 10% (0.14 +/- 0.12 mmol/L) in group 1, 25% (0.33 +/- 0.003 mmol/L) in group 2, and 6% (0.08 +/- 0.22 mmol/L) in group 3. No significant differences in mean lactate concentrations were found between any group or time point by analysis of variance (p > 0.90). A 50% relative increase in lactate concentrations between time 0 and 15 minutes occurred in zero of 21 subjects in group 1, four of 21 in group 2, and one of 21 in group 3 (p = 0.05 group 1 vs. group 2, Fisher's exact test).
Whole blood point-of-care lactate concentrations in healthy subjects do not change significantly over 15 minutes at either -1 degrees C or 23 degrees C, and the use of a tourniquet has no appreciable effect on lactate concentrations.
作者试图确定体外时间、温度和使用可移除止血带对即时检测静脉血乳酸浓度变化的影响。
这是一项针对健康志愿者的前瞻性随机试验。受试者被随机分为三组之一：第1组在不使用止血带抽取的血液上测量静脉乳酸浓度，并将样本置于冰中（-1℃）；第2组在不使用止血带抽取的血液上测量乳酸浓度，样本置于23℃；第3组在静脉穿刺前5分钟使用止血带抽取的血液上测量乳酸浓度，并将样本置于冰中（-1℃）。在所有三组中，于0、3、6、9、12和15分钟时使用即时检测设备测量乳酸浓度。使用双向重复测量方差分析来分析平均乳酸浓度。
80名受试者被随机分组，63名（每组21名）有完整数据。在15分钟期间，第1组乳酸浓度增加10%（0.14±0.12 mmol/L），第2组增加25%（0.33±0.003 mmol/L），第3组增加6%（0.08±0.22 mmol/L）。通过方差分析，在任何组或时间点之间均未发现平均乳酸浓度有显著差异（p>0.90）。第1组21名受试者中有0名、第2组21名中有4名、第3组21名中有1名在0至15分钟时乳酸浓度相对增加50%（第1组与第2组比较，p = 0.05，Fisher精确检验）。
健康受试者的全血即时检测乳酸浓度在-1℃或23℃下15分钟内无显著变化，且使用止血带对乳酸浓度无明显影响。
