Contribution of the Pre-Hospital Blood Lactate Level in the Pre-Hospital Orientation of Septic Shock: The LAPHSUS Study

Özet

Objective: In the pre-hospital setting, the assessment of septic shock severity is essential when determining the optimal initial in-hospital level ofcare. As clinical signs can be faulted, there is a need for an additional component to enhance the severity assessment and to decide on in-hospitaladmission in the intensive care unit (ICU) or in the emergency department (ED). Point-of-care medical devices by yielding blood lactate valuesince the pre-hospital setting may give an easy and valuable component for the severity assessment and decision-making. The aim of this study isto provide clinical evidence that the pre-hospital blood lactate level predicts the 30-day mortality in patients with septic shock.Methods: This trial is a prospective, observational, non-randomised controlled study. A total of 1,000 patients requiring a mobile ICU intervention for septic shock in the pre-hospital setting will be included. Pre-hospital blood lactate levels will not be taken into account to decide patients’treatments and/or ED or ICU admission. In the pre-hospital setting, each patient will benefit from two measurements of the blood lactate level:initial measurement at the first contact, and final measurement at the hospital admission with a specific point-of-care medical device.Conclusion: This study could provide clinical evidence that the pre-hospital blood lactate level predicts the 30-day mortality of patients withseptic shock. The results from this study could also prove the utility of the pre-hospital blood lactate level for the triage and early orientation ofpatients with septic shock.