© 2021 Australasian College for Emergency Medicine. Accuracy is ensured by extensive quality checks and calibrations that occur automatically with each cartridge run. i-STAT cartridges with the right amount of blood for testing. Hence, clinically a raised venous lactate concentration should not be attributed to prolonged tourniquet application. The i-STAT Alinity v delivers blood gas, acid-base, electrolyte, chemistry, and hematology measurements in a completely portable, handheld package. venous blood samples and so results presented here are for venous samples only. In the present study tourniquet application for blood collection did not significantly increase lactate concentration.
In the rest group after 15-min of tourniquet application the mean lactate concentration of the tourniquet versus non-tourniquet arm was 0.91 mmol/L (SD 0.55) versus 0.89 mmol/L (SD 0.46) (P = 0.99), respectively. 27 In the shock subgroup, the mean CO 2 difference was 6 mm Hg with a pH difference of 0.03. Testing on the i-STAT hand-held analyser only Do not use anticoagulated blood. This becomes even more apparent when evaluating arterial and venous blood gas analysis during cardiopulmonary resuscitation where much wider discrepancies are seen, sometimes with normal pH or only mild arterial acidemia. There was no clinically significant increase in lactate concentration in the tourniquet compared to non-tourniquet arm in all groups, across all tourniquet application times, and over a range of lactate concentrations. Arterial blood gas ABG Venous blood gas VBG gasses. There were 10 subjects per group the exercise groups achieved a mean maximum lactate concentration of 10.4 mmol/L (standard deviation 3.6) (exercise with immediate tourniquet application group) and 8.9 mmol/L (SD 2.5) (exercise with delayed tourniquet application group). The primary outcome was a clinically significant difference (>1 mmol/L) in tourniquet versus non-tourniquet arm lactate concentration. In all blood was drawn simultaneously from both cannulas at 0, 2.5, 5, 10 and 15-min post-tourniquet application and analysed for lactate on a point-of-care device.
Subjects were allocated to one of three groups rest (no activity), exercise (maximal exertion to elevate lactate concentrations) with immediate tourniquet application or exercise with delayed (5-min post-exercise) tourniquet application. A cannula was inserted into each arm, with a tourniquet remaining on one. This is a healthy volunteer study, in which subjects were their own controls. The objective of the present study was to determine the effect of tourniquet time on varying venous lactate concentrations. Some have concerns that tourniquet application for venous blood collection may falsely elevate venous lactate. Lactate is frequently utilised in clinical practice.
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