Léguillier Teddy, Jouffroy Romain, Boisson Marie, Boussaroque Agathe, Chenevier-Gobeaux Camille, Chaabouni Tarek, Vivien Benoît, Nivet-Antoine Valérie, Beaudeux Jean-Louis
Department of Clinical Biochemistry, Necker Hospital, AP-HP, Paris, France; UMR-S1140, Paris Descartes University, Faculty of Pharmaceutical Sciences of Paris, France.
SAMU 75, Medical Intensive Care Unit, Necker Hospital, AP-HP, Paris, France; Paris Descartes University, Faculty of Medicine, Paris, France.
Clin Biochem. 2018 May;55:9-14. doi: 10.1016/j.clinbiochem.2018.03.006. Epub 2018 Mar 6.
We evaluated if the StatStrip Xpress Meter, a Lactate point of care testing (POCT) handled device, could be a valuable tool in the mobile intensive care units (MICU) to assess the severity of septic patients.
We first investigated POCT analytical performance, then, using samples collected from 50 identified septic patients admitted to the intensive care unit (ICU), we compared lactate values obtained with the device to those obtained with four central laboratory analysers: one whole blood and three plasma-based methods.
Results were compared by least squares regression, Bland-Altman plot and by comparing concordance within clinically relevant lactate ranges. We observed a reliable analytical performance of the POCT (CVs < 3.8% for repeatability and <5.0% for reproducibility) an excellent correlation between POCT and central laboratory analysers (R: 0.96-0.98, slopes:0.83-0.90, intercepts: 0.02-0.03) and an excellent concordance of the POCT results to the central laboratory analyser results (98-100%).
Whatever the methodology used, lactate values obtained are comparable and transferable between POCT and central laboratory analysers meaning that POCT could be a valuable tool in the MICU to evaluate the severity of septic patients and to better manage their hospital triage.
我们评估了StatStrip Xpress血糖仪（一种用于即时检测（POCT）乳酸的设备）是否能成为移动重症监护病房（MICU）中评估脓毒症患者严重程度的重要工具。
我们首先研究了POCT的分析性能，然后，使用从50名入住重症监护病房（ICU）的已确诊脓毒症患者采集的样本，将该设备测得的乳酸值与四种中心实验室分析仪测得的值进行比较：一种全血检测法和三种基于血浆的检测法。
通过最小二乘回归、Bland-Altman图以及比较临床相关乳酸范围内的一致性来比较结果。我们观察到POCT具有可靠的分析性能（重复性CVs<3.8%，再现性CVs<5.0%），POCT与中心实验室分析仪之间具有良好的相关性（R：0.96 - 0.98，斜率：0.83 - 0.90，截距：0.02 - 0.03），并且POCT结果与中心实验室分析仪结果具有良好的一致性（98 - 100%）。
无论采用何种方法，POCT和中心实验室分析仪测得的乳酸值具有可比性且可相互转换，这意味着POCT可能是MICU中评估脓毒症患者严重程度并更好地管理其医院分诊的重要工具。
