Clinical Uses of Lactate and Lactate Clearance in Carbon Monoxide Poisoning

Abstract

Introduction:This study aimed to investigate lactate and lactate clearance and to determine the feasibility of the use of lactate clearance for assessing treatment efficacy in carbon monoxide (CO) poisoning.Methods:All patients aged 18 years and older with CO intoxication between 01.06.2016 and 28.02.2018 were included. COHb levels, initial (lactate-1), and post-treatment control lactate (lactate-2) levels, lactate clearance, type of treatment [normobaric, or hyperbaric oxygen therapy (HBOT)] were recorded. The receiver operating characteristic curve was configured to establish a cut-off point of initial lactate level with the calculated area under the curve (AUC) to predict the need for HBOT.Results:A total of 103 patients were included. There was a moderate correlation between COHb and lactate-1 (r=0.49; p<0.001) and a weak correlation between COHb and lactate clearance (r=0.291; p=0.003). A significantly higher increase was observed in lactate clearance in the HBOT group (p=0.017). The AUC value of initial lactate in predicting the need for HBOT was 0.708.Conclusion:The initial lactate level and lactate clearance are rapidly performed and effective markers that may be used in CO intoxication. Especially lactate clearance may provide valuable information in predicting the need for HBOT and assessing treatment efficacy as a monitorization marker.

Keywords

• lactate
• lactate clearance
• carbon monoxide poisoning
• emergency department