Identification and Quantitative Determination of Lactate Using Optical Spectroscopy-Towards a Noninvasive Tool for Early Recognition of Sepsis.

Karthik Budidha,Panayiotis A Kyriacou,Mohammad Mamouei,Meha Qassem,Pankaj Vadgama,Nystha Baishya

doi:10.3390/s20185402

Karthik Budidha, Panayiotis A Kyriacou + Show 4 more

Open Access

https://doi.org/10.3390/s20185402

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Abstract

Uninterrupted monitoring of serum lactate levels is a prerequisite in the critical care of patients prone to sepsis, cardiogenic shock, cardiac arrest, or severe lung disease. Yet there exists no device to continuously measure blood lactate in clinical practice. Optical spectroscopy together with multivariate analysis is proposed as a viable noninvasive tool for estimation of lactate in blood. As an initial step towards this goal, we inspected the plausibility of predicting the concentration of sodium lactate (NaLac) from the UV/visible, near-infrared (NIR), and mid-infrared (MIR) spectra of 37 isotonic phosphate-buffered saline (PBS) samples containing NaLac ranging from 0 to 20 mmol/L. UV/visible (300–800 nm) and NIR (800–2600 nm) spectra of PBS samples were collected using the PerkinElmer Lambda 1050 dual-beam spectrophotometer, while MIR (4000–500 cm−1) spectra were collected using the Spectrum two FTIR spectrometer. Absorption bands in the spectra of all three regions were identified and functional groups were assigned. The concentration of lactate in samples was predicted using the Partial Least-Squares (PLS) regression analysis and leave-one-out cross-validation. The regression analysis showed a correlation coefficient (R2) of 0.926, 0.977, and 0.992 for UV/visible, NIR, and MIR spectra, respectively, between the predicted and reference samples. The RMSECV of UV/visible, NIR, and MIR spectra was 1.59, 0.89, and 0.49 mmol/L, respectively. The results indicate that optical spectroscopy together with multivariate models can achieve a superior technique in assessing lactate concentrations.

Highlights

Once considered a simple by-product of anaerobic metabolism, lactate is recognized as an important intermediate in cellular bioenergetics [1]
There still subsists an unmet clinical need for noninvasive continuous blood lactate monitor that is easy-to-use, cost-effective, and produces reproducible results. To address this essential need, the current paper explores the possibility of using optical spectroscopy together with multivariate analysis as a feasible tool for noninvasive prediction of lactate concentration
Continuous measurement of elevated serum lactate levels in critically ill patients is of paramount importance

Summary

Introduction

Once considered a simple by-product of anaerobic metabolism, lactate is recognized as an important intermediate in cellular bioenergetics [1]. Lactate is used as a prognostic indicator for hypoperfusion due to its almost proportional production relationship with the presence of oxygen in tissues. Under healthy, resting conditions, anaerobic glycolysis converts approximately. 10% of the body’s pyruvate production into lactate. The lactate produced is predominantly due to red blood cells (80%) and leukocytes (13%) [2]. In conditions of inadequate perfusion with low oxygen delivery to the tissues, the anaerobic glycolysis increases. This, in turn, causes a build-up of its by-products, i.e., pyruvate, NADH, and H+ , and lactate [3]. The liver (20–30%), kidneys (20%), and the myocardium (5–15%) uptake the overproduced lactate, it is a saturable process

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