Comparison between Hemoglobin Levels and Lactate Blood Level as Predictor of HemotransfusionTriger

IntroductionTo investigate the role of blood lactate level as an important indicator for indicating the starting of hemotransfusion. In this regard the blood lactate level was compared with hemoglobin levels. Blood lactate level is considered to be a sensitive indicator in monitoring tissue oxygenation. Therefore this study aimed to evaluate the extent of considering the blood lactate level in decision-making for initiation of hemotransfusion and compare the improvementof the clinical outcomes with the results when hemoglobin is used as hemotransfusion trigger. Study designProspective observational. MethodsIn this prospective observing study were enrolled 59 patients undergoing hemotransfusion. Patients with APACHE score of above 24 were excluded from the study. Each patient at the time of admission was continuously monitored for vital parameters (i. e. systolic blood pressure, heart rate, etc) as well as for blood lactate levels and hemoglobin. Blood lactate and hemoglobin levels were measured also at 2 h after the first hemotransfusion and at 24h from the admission independently if the patient was hemotransfused again or not. The patients were first grouped in 2 groups according to the hemoglobin levels having as threshold the Hb level of 8gr/dl and then re-grouped again according to the blood lactate level having as threshold the blood lactate level of 2.4mol/L. ResultsWhen patients are grouped based on hemoglobin levels (less than or -8gr/dl) at the time of admission it was shown that there was no significant difference between the two groups for Hb levels at 2 h and 24 h after the initiation of the hemotransfusion. On the contrary, when patients are grouped based on blood lactate levels (less than or - 2, 4 mmol/L) the significant difference between the two groups for blood lactate level values at the time of admission continued to remain significant even at 2 h and 24 h after the initiation of the hemotransfusion. ConclusionsPatients with high blood lactate level at admission required more blood packs transfused and had a poorer morbidity and mortality compared with patients with lower blood lactate level value. No significant difference was found on this regard between patients with lower Hb value at admission compared with those with higher Hb value. A negative correlation between Hb and blood lactate level at the time of admission was demonstrated. It was also shown that the progressive increase of Hb values was not associated with a progressive decrease of blood lactate levels. It was concluded that blood lactate level is a better indicator of patients in need for hemotransfusion.