Anion Gap as a Screening Tool for Elevated Lactate in Patients with an Increased Risk of Developing Sepsis in the Emergency Department

Journal of Emergency Medicine

Volumn 36, Issue 4, 2009, Pages 391-394

  Berkman, Matthew ^a,b   Ufberg, Jacob ^c   Nathanson, Larry A ^a   Shapiro, Nathan I ^a  

^a HARVARD MEDICAL SCHOOL   (United States)

^b UNIVERSITY OF ARIZONA COLLEGE OF MEDICINE   (United States)

^c TEMPLE UNIVERSITY SCHOOL OF MEDICINE   (United States)

Author keywords

anion gap; lactate; sepsis

Indexed keywords

LACTIC ACID;

ADULT; ANION GAP; AREA UNDER THE CURVE; ARTICLE; COHORT ANALYSIS; CRITICALLY ILL PATIENT; DIAGNOSTIC ACCURACY; DISEASE COURSE; DISEASE MARKER; EMERGENCY WARD; HUMAN; INFECTION; LACTATE BLOOD LEVEL; MAJOR CLINICAL STUDY; OBSERVATIONAL STUDY; PATIENT REFERRAL; PRIORITY JOURNAL; PROSPECTIVE STUDY; RISK ASSESSMENT; SENSITIVITY AND SPECIFICITY; SEPSIS; STUDENT T TEST; TERTIARY HEALTH CARE; UNIVERSITY HOSPITAL; URBAN POPULATION;

ACID-BASE EQUILIBRIUM; DIAGNOSIS, DIFFERENTIAL; EMERGENCY MEDICAL SERVICES; HUMANS; LACTIC ACID; MASS SCREENING; PREVALENCE; RISK FACTORS; SENSITIVITY AND SPECIFICITY; SEPSIS;

EID: 64849089678     PISSN: 07364679     EISSN: None     Source Type: Journal    
DOI: 10.1016/j.jemermed.2007.12.020     Document Type: Article

References (10)

1. Rivers E., Nguyen B., Havstad S., et al. Early goal-directed therapy in the treatment of severe sepsis and septic shock. N Engl J Med 345 (2001) 1368-1377
2. Bakker J., Coffernils M., Leon M., et al. Blood lactate levels are superior to oxygen-derived variables in predicting outcome in human septic shock. Chest 99 (1991) 956-962
3. Smith I., Kumar P., Molloy S., et al. Base excess and lactate as prognostic indicators for patients admitted to intensive care. Intensive Care Med 27 (2001) 74-83
4. Shapiro N.I., Howell M.D., Talmor D., et al. Serum lactate as a predictor of mortality in emergency department patients with infection. Ann Emerg Med 45 (2005) 524-528
5. Levraut C., Bounatirou T., Ichai C., et al. Reliability of anion gap as an indicator of blood lactate in critically ill patients. Intensive Care Med 23 (1997) 417-422
6. Salem M.M., and Mujais S.K. Gaps in the anion gap. Arch Intern Med 152 (1992) 1625-1629
7. Rocktaeschel J., Morimatsu H., Uchino S., and Bellomo R. Unmeasured anions in critically ill patients: can they predict mortality?. Crit Care Med 31 (2003) 2131-2136
8. Singh R.N., Singh N.C., Hutchison J., and Moses G.C. Lower anion gap increases sensitivity in predicting elevated lactate. Clin Intensive Care 5 (1994) 221-224
9. Iberti T.J., Leibowitz A.B., Papadakos P.J., et al. Low sensitivity of the anion gap as a screen to detect hyperlactatemia in critically ill patients. Crit Care Med 18 (1991) 275-277
10. Mikulaschek A., Henry S.M., Donovan R., et al. Serum lactate is not predicted by anion gap or base excess after trauma resuscitation. J Trauma 40 (1996) 218-222