Too much testing?

نویسندگان

  • Pierre-Géraud Claret
  • Xavier Bobbia
  • Jean-Emmanuel de La Coussaye
چکیده

In their recent article in CHEST (January 2014) on the treatment of acute asthma with albuterol, Lewis et al 1 show that high levels of lactate during such treatment are highly prevalent; in addition, high plasma albuterol concentration is signifi cantly correlated with hyperlactatemia. In a previous case involving a woman with asthma, we described lactic acidosis (pH 7.29) and a high level of arterial lactate (10.47 mmol/L) after treatment with bronchodilator aerosols (terbutaline). 2 This level represents the highest level of lactate, without any grave consequences, that we were able to fi nd in the literature. We concur with Lewis et al 1 that hyperlactatemia, with or without lactic acidosis, is not necessarily a sign of immediate gravity and has no clinical consequences in these patients. We also question the utility of measuring lactates in acute asthma. Advanced tests have dramatically changed how diseases are diagnosed and treated. A great evolution in medicine! However, we have to keep in mind that clinical examination is more important than the results of these tests, even if hyperlactatemia is present. Laboratory tests should be targeted, and physicians should not order tests if they do not think they will aid in patient management. The study by Lewis et al 1 helps demonstrate this concept.

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عنوان ژورنال:
  • Chest

دوره 145 6  شماره 

صفحات  -

تاریخ انتشار 2014