False lactate project
Research type
Research Study
Full title
Can fist clenching after tourniquet application for venous sampling cause a falsely raised lactate on venous blood gas analysis?
IRAS ID
184158
Contact name
Christopher Bassford
Contact email
Sponsor organisation
University Hospitals Coventry and Warwickshire NHS Trust
Duration of Study in the UK
0 years, 5 months, 2 days
Research summary
Blood gas analysis performed within the Emergency Department (ED) can quickly provide a great deal of information. Included in this information is the blood concentration of lactic acid, also known as lactate. Lactate is a marker of anaerobic cellular activity, and is produced by tissues when oxygen supply in not sufficient for normal metabolism. Concentrations of lactate are used clinically as a non-specific marker of stress or strain to the body. In the correct context a moderately raised lactate can represent a severely ill patient and is a very useful tool to the emergency clinician. Venous rather than arterial sampling is usually performed for reasons of efficiency and patient comfort.
However, lactate is also increased by moderate exercise, when muscles require more oxygen than is being delivered by the blood. When venous blood is being taken, clinicians will often ask a patient to clench and unclench their fist. This is a technique to ‘’fill’’ the veins for easier venous blood sampling. This study hypothesises that fist clenching causes excess lactate production, and therefore a higher measured lactate in the sample than is truly representative of the patient’s situation. In some circumstances this could mislead a clinician into more aggressively treating a patient than is necessary.
This study will measure lactate levels in healthy volunteers with, and without, fist clenching during sampling to investigate if there is a significant difference in the lactate concentrations measured in their blood.REC name
North East - Newcastle & North Tyneside 1 Research Ethics Committee
REC reference
16/NE/0152
Date of REC Opinion
9 May 2016
REC opinion
Favourable Opinion