Contribution of the Pre-Hospital Blood Lactate Level in the Pre-Hospital Orientation of Septic Shock: The LAPHSUS Study [Turk J Anaesthesiol Reanim]
Turk J Anaesthesiol Reanim. Ahead of Print: TARD-42027 | DOI: 10.5152/TJAR.2019.42027  

Contribution of the Pre-Hospital Blood Lactate Level in the Pre-Hospital Orientation of Septic Shock: The LAPHSUS Study

Romain Jouffroy1, Jean Pierre Tourtier2, Guillaume Debaty3, Vincent Bounes4, Papa Gueye-ngalgou5, Benoit Vivien1
1Intensive Care Unit, Anesthesiology, SAMU, Necker Enfants Malades Hospital, Assistance Publique - Hôpitaux de Paris, Paris, France
2Fire Brigade of Paris, Paris, France
3Department of Emergency Medicine, SAMU 38, University Hospital of Grenoble Alps/CNRS/TIMC-IMAG UMR 5525, Grenoble, France
4Department of Emergency Medicine, SAMU 31, University Hospital of Toulouse, Toulouse, France
5SAMU 972 CHU de Martinique Pierre Zobda -Quitman Hospital 97261 Fort-de-France Martinique, France

Objective: In the pre-hospital setting, the assessment of septic shock severity is essential when determining the optimal initial in-hospital level of care. As clinical signs can be faulted, there is a need for an additional component to enhance the severity assessment and to decide on in-hospital admission in the intensive care unit (ICU) or in the emergency department (ED). Point-of-care medical devices by yielding blood lactate value since the pre-hospital setting may give an easy and valuable component for the severity assessment and decision-making. The aim of this study is to provide clinical evidence that the pre-hospital blood lactate level predicts the 30-day mortality in patients with septic shock.

Methods: This trial is a prospective, observational, non-randomised controlled study. A total of 1,000 patients requiring a mobile ICU intervention for septic shock in the pre-hospital setting will be included. Pre-hospital blood lactate levels will not be taken into account to decide patients’ treatments and/or ED or ICU admission. In the pre-hospital setting, each patient will benefit from two measurements of the blood lactate level: initial measurement at the first contact, and final measurement at the hospital admission with a specific point-of-care medical device.

Conclusion: This study could provide clinical evidence that the pre-hospital blood lactate level predicts the 30-day mortality of patients with septic shock. The results from this study could also prove the utility of the pre-hospital blood lactate level for the triage and early orientation of patients with septic shock.

Keywords: Blood lactate, pre-hospital setting, prediction, septic shock, severe sepsis.




Corresponding Author: Romain Jouffroy, France


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