#EMConf - Lactate for Pregnant Women in Septic Shock?
-Limited data, vulnerable population
-Consider interpreting the serum lactate concentrations for pregnant adults as you would for non-pregnant adults.
Study 1: Lactic Acid Measurement to Identify Risk of Morbidity from Sepsis in Pregnancy
-Retrospective cohort study of pregnant/postpartum adults evaluated in the ED with suspected SIRS/sepsis.
-Elevated lactate levels indicated the need for higher level of care.
-ICU admit, 2.6 mmol/L (p £ 0.04)
-Telemetry unit, 2.0 mmol/L (p £ 0.03)
-Non-admit reference, 1.6 mmol/L
-AOR of a transfer to the ICU/telemetry unit for each 1 mmol/L increase of lactate concentration was 2.34 (95% CI, 1.33-4.12)
-Concluded that elevated lactate levels in pregnant/postpartum adults with clinically suspected sepsis is associated with adverse maternal outcomes.
Study 2: Evaluation of Point-of-Care Maternal Venous Lactate Testing in Normal Pregnancy
-Prospective observational study of venous lactate levels collected during pregnancy.
-Mean Serum Lactate, mmol/L
-Study reference range, non-pregnant adults: 0.30-1.30
-Gestational age, 6-18 weeks: 0.86 ± 0.46 (n=199)
-Gestational age, 36-42 weeks: 1.15 ± 0.40 (n=47)
-Concluded that the serum lactate reference range for non-pregnant adults may be considered in early and late pregnancy.
Albright CM, Ali TN, Lopes V, et al. Lactic Acid Measurement to Identify Risk of Morbidity from Sepsis in Pregnancy. Am J Perinatol. 2015;32(5):481-486.
Maguire PJ, Finlay J, Power KA, et al. Evaluation of Point-of-Care Maternal Venous Lactate Testing in Normal Pregnancy. J Matern Fetal Neonatal Med. 2016;29(16):2607-2610.