Abstract
ObjectivesLactate is a major parameter in medical decision making. During labor, it is an indicator for fetal acidosis and immediate intervention. In the Emergency Department (ED), rapid analysis of lactate/blood gas is crucial for optimal patient care. Our objectives were to cross-compare-for the first time-two point-of-care testing (POCT) lactate devices with routine laboratory results using novel tight precision targets and evaluate different lactate cut-off concentrations to predict metabolic acidosis. Design and methodsBlood samples from the delivery room (n=66) and from the ED (n=85) were analyzed on two POCT devices, the StatStrip-Lactate (Nova Biomedical) and the iSTAT-1 (CG4+ cassettes, Abbott), and compared to the routine laboratory analyzer (ABL-735, Radiometer). Lactate concentrations were cross-compared between these analyzers. ResultsThe StatStrip correlated well with the ABL-735 (R=0.9737) and with the iSTAT-1 (R=0.9774) for lactate in umbilical cord blood. Lactate concentrations in ED samples measured on the iSTAT-1 and ABL-735 showed a correlation coefficient of R=0.9953. Analytical imprecision was excellent for lactate and pH, while for pO2 and pCO2 the coefficient of variation was relatively high using the iSTAT-1. ConclusionBoth POCT devices showed adequate analytical performance to measure lactate. The StatStrip can indicate metabolic acidosis in 1 μl blood and will be implemented at the delivery room.
Highlights
Lactate is a crucial metabolite produced under stress conditions, like hypoxia
In the absence of oxygen, glucose is converted into lactate, while normally glucose is fully oxidized in the cell mitochondria to efficiently produce energy
Results were statistically analyzed with EP-Evaluator (Version 10.3, David G Rhoads Associates, South Burlington, VT, USA) using the CLSI guidelines: Two-Instruments Comparison (CLSI:EP9), Alternate Method Comparison (CLSI:EP9A), Multiple Instrument Comparison and Complex Precision (CLSI:EP5A)
Summary
Lactate is a crucial metabolite produced under stress conditions, like hypoxia. In the absence of oxygen, glucose is converted into lactate, while normally glucose is fully oxidized in the cell mitochondria to efficiently produce energy (adenosine triphosphate, ATP). Intracellular produced lactate is secreted as lactic acid, resulting in metabolic acidosis. In case of severe sepsis, lactate is produced by micro-organisms, as these do not have mitochondria. Blood lactate is an indicator for metabolic acidosis and can serve as a single marker for immediate medical intervention. In the Emergency Department (ED) it can indicate sepsis and ischemia.
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
