![]() ![]() In the study reported here, we shift the focus to cancer patients who not only have cells producing more lactate but may be receiving treatment making them more susceptible to systemic infections. Previous studies have shown that POC devices are able provide reliable measurements of lactate levels in delivery rooms and emergency departments (ED). The processing technology used by new POC devices allow for a cost-effective, rapid, and efficient measurement of not only lactic acid levels but also of nucleic acid, proteins, and cells. The recent breakthrough in the design of electrochemical biosensors, field-effect transistors, and surface plasmon resonance sensors has led to massive improvements in the development of POC devices. Laboratory analytical techniques, blood gas analyzers, point-of-care (POC) devices, and other methods are used to measure the lactate level in the blood. Blood lactate concentration has been shown to reflect the progression of disease and is thus a very important factor to consider when making a diagnosis in critically ill patients, especially those with cancer. This association is even more important in cancer patients because not only do cancerous cells secrete lactate even in an abundance of oxygen, but cancer patients may also be immunosuppressed due to the cancer and its treatment, rendering them more susceptible to systemic infection. High levels of lactate in the blood, either from tumor lysis syndrome or sepsis, can precipitously cause death. Lactate is a metabolite resulting from the fermentation of glucose when tissues lack or cannot use oxygen for the oxidative phosphorylation of glucose into energy. Therefore, in subsequent decision-making, we recommend that if sepsis is suspected and BLAC determined by POCT is normal, nucleic acids, proteins, circulating cells, and interleukin-3 levels should also be obtained by POCT to confirm sepsis and/or rule out tumor lysis syndrome in patients with cancer. ![]() Importantly, in 2% of the cancer patients who presented emergently, BLAC determined by POCT and laboratory analysis did not agree. This finding suggests that POCT would suffice in most cases. There was a high correlation between POCT and laboratory analysis values of BLAC in cancer patients, with the results from both testing methods agreeing 96% of the time. Categorization of BLAC showed that 88.32% of the patients had BLAC that directly matched between the two tests 28 (10.22%) patients had a normal BLAC according to laboratory analysis but a high BLAC on POCT and four (1.46%) patients had a high BLAC according laboratory analysis but normal BLAC on POCT. The BLAC from POCT correlated well with the values from laboratory testing ( R = 0.925). ResultsĪ total of 274 patients met the criteria for the study. Regressions were performed together with an analysis categorizing the BLAC from both testing methods. Only those patients who had blood withdrawn for both testing methods within a 2-h timeframe were included in the study. ![]() This was a retrospective study in cancer patients whose BLAC had been determined by POCT and laboratory analysis. We have compared blood lactic acid concentrations (BLAC) in cancer patients obtained by point-of-care testing (POCT) and those measured by laboratory analysis in blood samples drawn within a short time of each other. Therefore, it is critical to determine the blood lactic acid level to timely identify who is at risk of sepsis and provide early intervention. In the emergency setting, it is important ascertain rapidly if lactic acid levels are high, either due to sepsis or tumor lysis syndrome, to effectively manage symptoms. Cancer patients are immunosuppressed and may present to an emergency department with atypical symptoms. ![]()
0 Comments
Leave a Reply. |
Details
AuthorWrite something about yourself. No need to be fancy, just an overview. ArchivesCategories |