{"pk":8537,"title":"Is Serum Lactate Necessary in Patients with Normal Anion Gap and Serum Bicarbonate?","subtitle":null,"abstract":"Introduction: \nThere has been an increase in patients having serum lactate drawn in emergency situations. The objective of this study was to determine whether or not it was necessary to obtain a lactate level in patients with a normal serum bicarbonate level and anion gap.\nMethods: \nThis is a retrospective chart review evaluation of 304 patients who had serum lactate and electrolytes measured in an emergency setting in one academic medical center.\nResults: \nIn 66 patients who had elevated serum lactate (>2.2mmol/L), 45 (68%) patients had normal serum bicarbonate (SB) (greater than 21 mmol/L). Normal anion gap (AG) (normal range <16 mEq/l) was found in 51 of the 66 patients (77%).\nConclusion: \nWe found that among patients with elevated serum lactate, 77% had a normal anion gap and 68% had normal serum bicarbonate. We conclude serum lactate should be drawn based on clinical suspicion of anaerobic tissue metabolism independent of serum bicarbonate or anion gap values. [West J Emerg Med. 2015;16(3):364–366.]","language":"en","license":{"name":"Creative Commons Attribution 4.0","short_name":"CC BY 4.0","text":"Attribution — You must give appropriate credit, provide a link to the license, and indicate if changes were made. You may do so in any reasonable manner, but not in any way that suggests the licensor endorses you or your use.\r\n\r\nNo additional restrictions — You may not apply legal terms or technological measures that legally restrict others from doing anything the license permits.","url":"https://creativecommons.org/licenses/by/4.0"},"keywords":[{"word":"Serum lactate, shock, emergency laboratory assessment"}],"section":"Critical Care","is_remote":true,"remote_url":"https://escholarship.org/uc/item/3gd074cw","frozenauthors":[{"first_name":"Daniel","middle_name":"","last_name":"Aronovich","name_suffix":"","institution":"Mount Sinai Medical Center, Department of Emergency Medicine, Miami Beach, Florida","department":"None"},{"first_name":"Maykel","middle_name":"","last_name":"Trotter","name_suffix":"","institution":"Mount Sinai Medical Center, Department of Internal Medicine, Miami Beach, Florida","department":"None"},{"first_name":"Cynhtia","middle_name":"","last_name":"Rivera MD","name_suffix":"","institution":"Mount Sinai Medical Center, Department of Internal Medicine, Miami Beach, Florida","department":"None"},{"first_name":"Michael","middle_name":"","last_name":"Dalley","name_suffix":"","institution":"Mount Sinai Medical Center, Department of Internal Medicine, Miami Beach, Florida","department":"None"},{"first_name":"David","middle_name":"","last_name":"Farcy","name_suffix":"","institution":"Mount Sinai Medical Center, Department of Emergency Medicine, Miami Beach, Florida","department":"None"},{"first_name":"Michel","middle_name":"","last_name":"Betancourt","name_suffix":"","institution":"Mount Sinai Medical Center, Department of Pathology, Miami Beach, Florida","department":"None"},{"first_name":"Lydia","middle_name":"","last_name":"Howard","name_suffix":"","institution":"Mount Sinai Medical Center, Department of Pathology, Miami Beach, Florida","department":"None"},{"first_name":"Sharon","middle_name":"","last_name":"Licciardi","name_suffix":"","institution":"Mount Sinai Medical Center, Department of Pathology, Miami Beach, Florida","department":"None"},{"first_name":"Luigi","middle_name":"","last_name":"Cubeddu","name_suffix":"","institution":"Nova Southeastern University, Health Professions Division, Fort Lauderdale, Florida","department":"None"},{"first_name":"Robert","middle_name":"","last_name":"Goldszer","name_suffix":"","institution":"Mount Sinai Medical Center, Department of Internal Medicine, Miami Beach, Florida","department":"None"}],"date_submitted":"2014-09-16T07:43:32+05:30","date_accepted":"2014-09-16T07:43:32+05:30","date_published":"2015-04-03T05:21:10+05:30","render_galley":null,"galleys":[{"label":"","type":"pdf","path":"https://journalpub.escholarship.org/westjem/article/8537/galley/4922/download/"}]}