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International Journal of Endocrinology
Volume 2009, Article ID 390975, 8 pages
http://dx.doi.org/10.1155/2009/390975
Research Article

Clinical Evaluation of Subcutaneous Lactate Measurement in Patients after Major Cardiac Surgery

1Department of Internal Medicine, Medical University Graz, Auenbruggerplatz 15, 8036 Graz, Austria
23rd Department of Medicine, 1st Faculty of Medicine, Charles University, Ruská 87, 100 00 Prague, Czech Republic
3Joanneum Research GmbH, Institute of Medical System Technologies and Health Management, Elisabethstraβe 11a, 8010 Graz, Austria

Received 29 September 2008; Revised 8 January 2009; Accepted 3 March 2009

Academic Editor: Andre Marette

Copyright © 2009 Martin Ellmerer et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Minimally invasive techniques to access subcutaneous adipose tissue for glucose monitoring are successfully applied in type1 diabetic and critically ill patients. During critical illness, the addition of a lactate sensor might enhance prognosis and early intervention. Our objective was to evaluate SAT as a site for lactate measurement in critically ill patients. In 40 patients after major cardiac surgery, arterial blood and SAT microdialysis samples were taken in hourly intervals. Lactate concentrations from SAT were prospectively calibrated to arterial blood. Analysis was based on comparison of absolute lactate concentrations (arterial blood vs. SAT) and on a 6-hour lactate trend analysis, to test whether changes of arterial lactate can be described by SAT lactate. Correlation between lactate readings from arterial blood vs. SAT was highly significant ( , ). Nevertheless, 42% of SAT lactate readings and 35% of the SAT lactate trends were not comparable to arterial blood. When a 6-hour stabilization period after catheter insertion was introduced, 5.5% of SAT readings and 41.6% of the SAT lactate trends remained incomparable to arterial blood. In conclusion, replacement of arterial blood lactate measurements by readings from SAT is associated with a substantial shortcoming in clinical predictability in patients after major cardiac surgery.