Contents lists available at ScienceDirect Clinical Biochemistry journal homepage: www.elsevier.com/locate/clinbiochem Lactate POCT in mobile intensive care units for septic patients? A comparison of capillary blood method versus venous blood and plasma- based reference methods Teddy Léguillier a,e , Romain Jouffroy b,f , Marie Boisson a , Agathe Boussaroque a , Camille Chenevier-Gobeaux c , Tarek Chaabouni d , Benoît Vivien b,f , Valérie Nivet-Antoine a,e , Jean-Louis Beaudeux a,g, ⁎ a Department of Clinical Biochemistry, Necker Hospital, AP-HP, Paris, France b SAMU 75, Medical Intensive Care Unit, Necker Hospital, AP-HP, Paris, France c Department of Automated Biological Diagnosis, Cochin Hospital, Hôpitaux Universitaires Paris Centre (HUPC), Assistance Publique des Hôpitaux de Paris (AP-HP), Paris, France d Department of Clinical Biochemistry, Bichat-Claude Bernard Hospital, AP-HP, Paris, France e UMR-S1140, Paris Descartes University, Faculty of Pharmaceutical Sciences of Paris, France f Paris Descartes University, Faculty of Medicine, Paris, France g UMR-S1139, Paris Descartes University, Faculty of Pharmaceutical Sciences of Paris, France ARTICLE INFO Keywords: Lactate Septic patients Analytical performances Sepsis Point-of-care testing (POCT) ABSTRACT Aim of the study: We evaluated if the StatStrip Xpress Meter, a Lactate point of care testing (POCT) handled device, could be a valuable tool in the mobile intensive care units (MICU) to assess the severity of septic patients. Methods: We first investigated POCT analytical performance, then, using samples collected from 50 identified septic patients admitted to the intensive care unit (ICU), we compared lactate values obtained with the device to those obtained with four central laboratory analysers: one whole blood and three plasma-based methods. Results: Results were compared by least squares regression, Bland-Altman plot and by comparing concordance within clinically relevant lactate ranges. We observed a reliable analytical performance of the POCT (CVs < 3.8% for repeatability and < 5.0% for reproducibility) an excellent correlation between POCT and central laboratory analysers (R 2 : 0.96–0.98, slopes:0.83–0.90, intercepts: 0.02–0.03) and an excellent con- cordance of the POCT results to the central laboratory analyser results (98–100%). Conclusion: Whatever the methodology used, lactate values obtained are comparable and transferable between POCT and central laboratory analysers meaning that POCT could be a valuable tool in the MICU to evaluate the severity of septic patients and to better manage their hospital triage. 1. Introduction Measurement of blood lactate level for septic patients is actually used to differentiate sepsis from septic shock [1–4]. This differentiation is a fundamental step in influencing the prehospital patient pathway between the emergency department (ED) and the intensive care unit (ICU) [5]. Many of septic patients are transported by mobile intensive care units (MICU) to hospital [6,7]. Thus, measurement of blood lactate level during the pre-hospital phase could help MICU to determine the prognostic severity of these patients and, thus, better manage their hospital management pathway [5]. In this context, the use of a point of care (POC) blood lactate monitoring system (BLMS) seems to be clinically justified. However, no study has compared lactate values measured with central laboratory analysers (plasma and venous whole blood methods) and POC BLMS (capillary whole blood method) in real conditions of use. In this study, we compared lactate values obtained with POC BLMS and central laboratory analysers using capillary whole blood, venous whole blood and plasma samples collected from septic patients admitted to the ICU. In accordance with French Good La- boratory practice, we both evaluated the analytical performance of a POC BLMS, the StatStrip Lactate Xpress Meter, and compared it to plasma based lactate central laboratory methods used at the three hospital sites in Paris [8]. https://doi.org/10.1016/j.clinbiochem.2018.03.006 Received 5 January 2018; Received in revised form 20 February 2018; Accepted 6 March 2018 ⁎ Corresponding author at: Department of Clinical Chemistry, Necker Hospital, AP-HP, 149 rue de Sèvres, 75015 Paris, France. E-mail address: jean-louis.beaudeux@inserm.fr (J.-L. Beaudeux). Clinical Biochemistry xxx (xxxx) xxx–xxx 0009-9120/ © 2018 The Canadian Society of Clinical Chemists. Published by Elsevier Inc. All rights reserved. Please cite this article as: Léguillier, T., Clinical Biochemistry (2018), https://doi.org/10.1016/j.clinbiochem.2018.03.006