Assessment of a portable lactate meter for field use in the white rhinoceros (Ceratotherium simum).

Georgina C Cole,Adrian S.W Tordiffe,Gerhard Steenkamp

doi:10.4102/ojvr.v84i1.1399

Georgina C Cole, Adrian S.W Tordiffe + Show 1 more

Open Access

https://doi.org/10.4102/ojvr.v84i1.1399

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Abstract

Blood lactate is a predictor of mortality in critically ill humans and animals. Handheld lactate meters have the potential to be used in the field to evaluate the condition of severely injured rhinoceroses but have not been compared with laboratory-based methods. Agreement between a handheld lactate meter and a laboratory method was assessed, as was the stability of rhino blood lactate in the anticoagulant sodium fluoride/potassium oxalate (fluoride/oxalate). Blood samples were obtained from 53 white rhinos that had been immobilised for management reasons. Lactate was measured by means of a handheld meter using whole blood in heparin (WBHEP), whole blood in fluoride/oxalate (WBFO) and fluoride/oxalate plasma (PFO). Results were recorded in both blood (BL) and plasma (PL) modes and compared to an established laboratory method for measuring plasma lactate. To assess the stability of lactate over time, blood lactate in fluoride/oxalate was measured on the handheld meter at intervals for up to 91 h. Agreement was best using WBFO in PL mode, with small bias (−0.16), tight 95% limits of agreement (LOA) (−1.46, 1.14) and a Pc (95% CI) of 0.97 (0.92, 0.99). The agreement was improved for all sample types when using the PL mode compared to the blood lactate (BL) mode. Blood lactate was stable in fluoride/oxalate for 91 h, with a mean change from baseline of 0.15 (−0.178, 0.478) mmol/L (mean, 95% CI). The handheld meter was found to be suitable for field use in white rhinos but provided more reliable results with the device in PL mode. Furthermore, rhino blood lactate was found to be stable in fluoride/oxalate for as long as 3 days.

Highlights

Lactate is produced during anaerobic glycolysis where the conversion of pyruvate to lactate facilitates continued adenosine triphosphate (ATP) production in the absence of oxygen (Lagutchik et al 1996)
Lactate measured with the Accutrend for all sample types combined ranged from 0.9 mmol/L to 13.8 mmol/L in BL mode and 0.8 mmol/L to 16.5 mmol/L in PL mode
The highest level of agreement with a small bias, narrowest limits of agreement (LOA) and Pc closest to one was seen when whole blood in fluoride/oxalate (WBFO) was used on the Accutrend in the PL mode

Summary

Introduction

Lactate is produced during anaerobic glycolysis where the conversion of pyruvate to lactate facilitates continued adenosine triphosphate (ATP) production in the absence of oxygen (Lagutchik et al 1996). Blood lactate measurement in human patients has been extensively studied and demonstrated to be an effective predictor of mortality and useful in monitoring response to therapy in numerous critically ill patient groups (Aslar et al 2004; Cerovic et al 2003; Fall & Szerlip 2005; Lee D Cady et al 1973; McNelis et al 2001; Nguyen et al 2004). Lactate measurement has prognostic value in systemically ill animals (Lagutchik et al 1998; Stevenson et al 2007b), dogs with hypotension (Ateca, Dombrowski & Silverstein 2015), septic peritonitis (Cortellini, Seth & Kellett-Gregory 2014) and babesiosis (Nel et al 2004). Lactate is a predictor of gastric necrosis and outcome in dogs with gastric dilatation-volvulus (De Papp, Drobatz & Hughes 1999)

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