I was lucky enough to record a new podcast with Dr Seth Trueger – inspired by the recent online discussions around lactate, or more specifically lactate-clearance as a marker, or a goal of therapy in the treatment of septic patients.
This is a topic my team will be covering at the ACEM Winter Symposium here in Broome this weekend. It has been a weird preparation for our discussion in front of a whole bunch of ED Specialists – everytime I sit down to plan the talk I see another FOAMed resource or opinion which changes the landscape.
This podcast needs a bit of background in order for the whole conversation to make a bit of sense.
Lactate Clearance has been around for 10 years or so as a therapeutic goal – or at least of a marker of “winning” when we are resuscitating septic patients.
Nguyen, Rivers and co popularised lactate clearance as a marker of improvement in 2004 – a few years after the original EGDT trials by Rivers.
Then in 2009 Jones et al did a comparison between SvcO2 and lactate as markers to guide therapy in sepsis resuscitation – they showed they both worked equally as well. Jones et al showed it was “non-inferior” to SvCO2 to guide resuscitation.
I am a GP working in Broome, NW of Western Australia. I work as a hospital DMO (District Med Officer) doing Emergency, Anaesthestics, some Obstetrics and a lot of miscellaneous primary care. Also on the web as @broomedocs | + Casey Parker | Contact