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Lactate levels correlated with pulmonary complications in patients with femoral fractures
Results from this study of patients with femoral shaft fractures treated with reamed intramedullary nailing within 24 hours of hospital admission showed median admission lactate of 3.7 mmol/L correlated with at least 5 days of mechanical ventilation. However, investigators found a preoperative lactate level of 2.8 mmol/L was not linked with longer ventilation.
Researchers retrospectively identified 414 adult patients with femoral shaft fractures treated with reamed intramedullary nailing (IMN) at three academic, tertiary trauma centers within 24 hours of admission. Investigators recorded data including mechanism of injury, vital signs, injury characteristics, admission glucose value, time to definitive fixation with reamed IMN, preoperative hemoglobin levels, concomitant pelvic fractures, open femur factures and bilateral femur fractures. They also recorded the requirement for an initial 24-hour transfusion of packed red blood cells and fresh frozen plasma.
Findings showed 294 patients had an initial lactate level of at least 2.5 mmol/L. Investigators noted that at the time of admission, none of the patients had a lactate level of less than 2.5 mmol/L and that this reading increased hours before the surgical intervention. Investigators found no differences in pulmonary complications for patients who presented with a minimum level of 2.5 mmol/L.
According to researchers, patients had a median admission lactate of 3.7 mmol/L. They found a median preoperative lactate of 2.8 mmol/L. Overall, 62.6% of patients had elevated levels prior to fixation. After adjusting for confounding variables, results from the multivariable linear regression analysis showed admission lactate was associated with mechanical ventilation duration and logistic regression revealed admission lactate significantly correlated with pulmonary complications. Investigators noted preoperative lactate was not a risk factor for pulmonary complications. ‒ by Monica Jaramillo
Disclosures: Richards reports no relevant financial disclosures. Please see the full study for a list of all other authors’ relevant financial disclosures.