Impact of a Systematic Point of Care Testing Lactate Measurement on Reducing Resuscitation Room Length of Stay

Background: In the emergency departments (ED), lactate is a potential diagnostic and prognostic biomarker. The goal of our study was to evaluate the usefulness of a systematic lactate measurement with a point of care testing (POCT) to reduce resuscitation room length of stay. Methods: This is a prospective two-centric study in ED. Patients were enrolled into two phases. During the first (September to December 2014) phase, lactate measurement was systematically realized with POCT in all patients aged above 18 years, transferred into the resuscitation room by the triage nurse and during the second (March to April 2015) phase, the lactate order was decided by the clinician in charge and the lactate was measured in the central lab. Results: Data are presented with mean +/- SD and median [interquartile]. 833 patients were included, 397 during the phase 1 and 436 during the phase 2 (mean age 63 +/- 23 vs. 59 +/- 24 years, P = 0.03). In phase 1 (with POCT) [N = 397], the lactate mean value was 2.0 +/- 1.9 mmol/l and in phase 2 (N = 70/436), the lactate mean value was 2.2 +/- 1.9 mmol/l (P = 0.55). The length of stay in the resuscitation room was not decreased with POCT (165 [95-265] vs. 170 [100-260] min respectively, P = 0.76). Conclusion: Our study failed to demonstrate that the use of lactate POCT reduced the length of stay, for patients admitted into the resuscitation room.