2.50
Hdl Handle:
http://hdl.handle.net/10755/344127
Category:
Abstract
Type:
Poster
Title:
Intraosseous and Venous Blood Lactate Levels Correlate; PT/INR Do Not
Author(s):
Montez, Diana; Puga, Tatiana; Miller, Larry; Garcia, Mireya; Davlantes,Chris; Saussy, Juliette; Philbeck, Thomas
Lead Author STTI Affiliation:
Non-member
Author Details:
Diana Montez, BSN, RN, diana.montez@vidacare.com; Tatiana Puga, BS; Larry Miller, MD; Mireya Garcia; Chris Davlantes, MD, FACEP; Juliette Saussy, MD, FACEP; Thomas Philbeck, PhD
Abstract:
Research Abstract Purpose: Intraosseous (IO) vascular access is useful for fluid and medication delivery and blood sampling when intravenous access is difficult or impossible. Serum lactate is a potentially useful biomarker when managing patients with severe sepsis or trauma. IO blood values correlate with peripheral intravenous (IV) blood values for a number of laboratory tests, with little clinical data for the suitability of IO blood for determining lactate and PT/INR levels. The objective was to add to available data comparing IO marrow/blood (initial 1 mL aspirate), IO blood (subsequent aspirate), and IV and capillary blood to determine if there is a correlation between specimens for serum lactate and PT/INR levels. Design: Study data presented was collected from two-single center prospective studies. Setting: The studies were conducted at a teaching institution associated with a local university. Participants/Subjects: Healthy, non-pregnant female and male volunteers 21 years or older with no known contraindications to IO insertion were recruited by word of mouth from local EMS agencies and community. Exclusions were related to additional procedures done with this protocol (known infection, imprisoned, cognitively impaired, taking anticoagulants, allergies or sensitivity to lidocaine, shellfish or iodine). The study was conducted in accordance with Good Clinical Practice as defined by the International Conference on Harmonization (ICH) guidelines, and applicable regulations including, where applicable, the Declaration of Helsinki. Methods: The studies were IRB approved and volunteers were consented. For 30 subjects, IO and IV specimens were collected; 10 had capillary blood and IO marrow/blood collection as well. The IO specimens were drawn from proximal humerus and tibial catheters (EZ-IO®, Vidacare Corp, Shavano Park, TX). Analyses for lactate and PT/INR were done with an i-STAT® point-of-care analyzer and lactates were also obtained with the Lactate Plus analyzer. Means and Pearson's correlation were computed to assess the relationship between venous, capillary and IO blood and blood/marrow results. Results/Outcomes: Specimens analyzed using the i-STAT® had a significant correlation between IV blood and IO marrow/blood (r=0.76, n=20, p<.001), and between IV blood and IO blood (r=0.72, n=46, p<.001). Capillary and IV blood analyzed using the Lactate Plus lacked correlation. When IO blood specimens were analyzed using the i-STAT® and matching specimens were analyzed using the Lactate Plus, means appeared similar, but lacked significant correlation. The absence of correlation may be due to the smaller sample size (n=10).There was no correlation between IO and IV blood for PT/INR levels. Implications: Lactate levels obtained from IO specimens appear comparable to lactate levels from IV blood, reflected in a positive correlation. The PT/INR levels did not correlate. Specimen collection from healthy subjects was a study limitation. Further investigation is needed to determine if the relationship between IO and IV lactate values exists in patients when lactic acidosis is a factor, such as in ill or injured patients. If the relationship exists in actual patients IO blood lactate results may serve as a quick reference to alert the clinician to prepare for treatment for impending or current shock.
Keywords:
Blood; Intraosseous and Venous Blood Lactate Levels
Repository Posting Date:
4-Feb-2015
Date of Publication:
4-Feb-2015
Conference Date:
2014
Conference Name:
2014 ENA Annual Conference
Conference Host:
Emergency Nurses Association
Conference Location:
Indianapolis, Indiana, U.S.A.
Description:
2014 ENA Annual Conference Theme: Safe Practice, Safe Care. Held at the Indiana Convention Center
Note:
This is an abstract-only submission. If the author has submitted a full-text item based on this abstract, you may find it by browsing the Virginia Henderson Global Nursing e-Repository by author. If author contact information is available in this abstract, please feel free to contact him or her with your queries regarding this submission. Alternatively, please contact the conference host, journal, or publisher (according to the circumstance) for further details regarding this item. If a citation is listed in this record, the item has been published and is available via open-access avenues or a journal/database subscription. Contact your library for assistance in obtaining the as-published article.

Full metadata record

DC FieldValue Language
dc.language.isoen_USen_GB
dc.type.categoryAbstracten_GB
dc.typePosteren_GB
dc.titleIntraosseous and Venous Blood Lactate Levels Correlate; PT/INR Do Noten_GB
dc.contributor.authorMontez, Dianaen_GB
dc.contributor.authorPuga, Tatianaen_GB
dc.contributor.authorMiller, Larryen_GB
dc.contributor.authorGarcia, Mireyaen_GB
dc.contributor.authorDavlantes,Chrisen_GB
dc.contributor.authorSaussy, Julietteen_GB
dc.contributor.authorPhilbeck, Thomasen_GB
dc.contributor.departmentNon-memberen_GB
dc.author.detailsDiana Montez, BSN, RN, diana.montez@vidacare.com; Tatiana Puga, BS; Larry Miller, MD; Mireya Garcia; Chris Davlantes, MD, FACEP; Juliette Saussy, MD, FACEP; Thomas Philbeck, PhDen_GB
dc.identifier.urihttp://hdl.handle.net/10755/344127-
dc.description.abstractResearch Abstract Purpose: Intraosseous (IO) vascular access is useful for fluid and medication delivery and blood sampling when intravenous access is difficult or impossible. Serum lactate is a potentially useful biomarker when managing patients with severe sepsis or trauma. IO blood values correlate with peripheral intravenous (IV) blood values for a number of laboratory tests, with little clinical data for the suitability of IO blood for determining lactate and PT/INR levels. The objective was to add to available data comparing IO marrow/blood (initial 1 mL aspirate), IO blood (subsequent aspirate), and IV and capillary blood to determine if there is a correlation between specimens for serum lactate and PT/INR levels. Design: Study data presented was collected from two-single center prospective studies. Setting: The studies were conducted at a teaching institution associated with a local university. Participants/Subjects: Healthy, non-pregnant female and male volunteers 21 years or older with no known contraindications to IO insertion were recruited by word of mouth from local EMS agencies and community. Exclusions were related to additional procedures done with this protocol (known infection, imprisoned, cognitively impaired, taking anticoagulants, allergies or sensitivity to lidocaine, shellfish or iodine). The study was conducted in accordance with Good Clinical Practice as defined by the International Conference on Harmonization (ICH) guidelines, and applicable regulations including, where applicable, the Declaration of Helsinki. Methods: The studies were IRB approved and volunteers were consented. For 30 subjects, IO and IV specimens were collected; 10 had capillary blood and IO marrow/blood collection as well. The IO specimens were drawn from proximal humerus and tibial catheters (EZ-IO®, Vidacare Corp, Shavano Park, TX). Analyses for lactate and PT/INR were done with an i-STAT® point-of-care analyzer and lactates were also obtained with the Lactate Plus analyzer. Means and Pearson's correlation were computed to assess the relationship between venous, capillary and IO blood and blood/marrow results. Results/Outcomes: Specimens analyzed using the i-STAT® had a significant correlation between IV blood and IO marrow/blood (r=0.76, n=20, p<.001), and between IV blood and IO blood (r=0.72, n=46, p<.001). Capillary and IV blood analyzed using the Lactate Plus lacked correlation. When IO blood specimens were analyzed using the i-STAT® and matching specimens were analyzed using the Lactate Plus, means appeared similar, but lacked significant correlation. The absence of correlation may be due to the smaller sample size (n=10).There was no correlation between IO and IV blood for PT/INR levels. Implications: Lactate levels obtained from IO specimens appear comparable to lactate levels from IV blood, reflected in a positive correlation. The PT/INR levels did not correlate. Specimen collection from healthy subjects was a study limitation. Further investigation is needed to determine if the relationship between IO and IV lactate values exists in patients when lactic acidosis is a factor, such as in ill or injured patients. If the relationship exists in actual patients IO blood lactate results may serve as a quick reference to alert the clinician to prepare for treatment for impending or current shock.en_GB
dc.subjectBlooden_GB
dc.subjectIntraosseous and Venous Blood Lactate Levelsen_GB
dc.date.available2015-02-04T11:26:58Z-
dc.date.issued2015-02-04-
dc.date.accessioned2015-02-04T11:26:58Z-
dc.conference.date2014en_GB
dc.conference.name2014 ENA Annual Conferenceen_GB
dc.conference.hostEmergency Nurses Associationen_GB
dc.conference.locationIndianapolis, Indiana, U.S.A.en_GB
dc.description2014 ENA Annual Conference Theme: Safe Practice, Safe Care. Held at the Indiana Convention Centeren_GB
dc.description.noteThis is an abstract-only submission. If the author has submitted a full-text item based on this abstract, you may find it by browsing the Virginia Henderson Global Nursing e-Repository by author. If author contact information is available in this abstract, please feel free to contact him or her with your queries regarding this submission. Alternatively, please contact the conference host, journal, or publisher (according to the circumstance) for further details regarding this item. If a citation is listed in this record, the item has been published and is available via open-access avenues or a journal/database subscription. Contact your library for assistance in obtaining the as-published article.en_GB
All Items in this repository are protected by copyright, with all rights reserved, unless otherwise indicated.