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Relocation of blood gas laboratory to the emergency department helps decrease lactic acid values.

Jared Brazg1, Phyllis Huang1, Corey Weiner1

  • 1Maimonides Medical Center, Department of Emergency Medicine, Brooklyn, New York, United States.

The American Journal of Emergency Medicine
|March 22, 2018
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Moving blood gas analysis to the emergency department (ED) improves lactic acid (LA) accuracy. ED measurements showed lower mean LA values, suggesting enhanced reliability for critical care decisions.

Keywords:
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Area of Science:

  • Clinical Chemistry
  • Emergency Medicine
  • Laboratory Science

Background:

  • Emergency physicians utilize Lactic Acid (LA) levels for critical clinical decisions.
  • Accurate LA measurements are crucial for timely patient management.
  • Blood gas analysis location can influence sample integrity and results.

Purpose of the Study:

  • To determine if blood gas laboratory location affects the accuracy of emergency department (ED) lactic acid (LA) samples.
  • To investigate the association between the location of blood gas analysis (ED vs. satellite lab) and LA measurement accuracy.
  • To compare LA values obtained from samples analyzed in the ED versus a satellite laboratory (SL).

Main Methods:

  • Retrospective analysis of 21,595 venous and arterial blood gas samples from June 2015 to September 2016.
  • Samples were categorized into two groups: pre-relocation (SL) and post-relocation (ED) of the blood gas laboratory.
  • Statistical comparison (t-test, chi-square) of LA, potassium, and creatinine values between the SL and ED groups.

Main Results:

  • A significant difference in mean lactate values was observed between the SL group (2.21 mmol/L) and the ED group (1.99 mmol/L) (p < 0.0001).
  • The ED group demonstrated lower mean LA values compared to the SL group.
  • Potassium values showed a statistically significant difference (p=0.022), while creatinine values did not differ significantly.

Conclusions:

  • Relocating blood gas analysis to the ED may enhance the accuracy of lactic acid measurements.
  • ED-based blood gas analysis provides more reliable LA results compared to satellite laboratory analysis.
  • Consideration should be given to centralizing blood gas laboratories within the ED to improve the accuracy of critical biomarkers like LA.