lactate in serum/plasma/blood
Reference interval
Principle
The Kodak Ektachem Clinical Chemistry Slide (LAC) is a dry, multilayered, self-contained analytical element coated on a transparent polyester support.
A 10 microliter drop of sample is deposited on the slide & is evenly distributed by the spreading layer. Lactate in the sample is oxidized by the lactate oxidase to pyruvate & H2O2. The H2O2 generated oxidizes the 4-aminoantipyrene, 1,7-dihydroxy- naphthalene chromogen system in a horseradish peroxidase-catalyzed reaction & results in a dye complex. The sample is incubated for 5 minutes & the intensity of the dye complex is measured spectrophotometrically.
Clinical significance
- lactate is the end product of the anaerobic metabolism of glucose
- lactic acidosis results from local tissue hypoxia caused by dehydration, poor perfusion, as a result of shock (circulatory collapse) or cardiac failure
- mortality risk increases with increasing plasma lactate level in patients with sepsis or suspected infection[7]
Increases
- strenuous muscular exercise
- systemic infections
- shock
- hypoxia
- metabolic acidosis
- diabetic ketoacidosis
- nonketotic acidosis
- type 1 glycogen storage disease
- enzyme defects
- alcoholism
- neoplasia
- toxicity, including salicylate poisoning
Specimen
Patient Preparation: Draw the specimen when the patient is at rest without the use of a tourniquet or within 3 minutes of applying the tourniquet, but before releasing the tourniquet. The patient should avoid any exercise of the arm or hand before or during collection of the specimen.
Sample Preparation: Collect the specimen by the venipuncture technique described in patient preparation above. The combination of 2.5 mg/mL of sodium fluoride & 2.0 mg/mL of potassium oxalate is effective as an anticoagulant & antiglycolytic substance. Heparinized plasma is acceptable, but precautions must be taken to retard glycolysis by keeping the whole blood on ice & then immediately separating the plasma from the cells. Specimens must be collected in tubes at least half full.
Sample requirements: Minimum- 0.5mL sodium fluoride/potassium oxalate plasma. Optimum- 1.0mL sodium fluoride/potassium oxalate plasma.
More general terms
More specific terms
Additional terms
Component of
References
- ↑ Kodak Ektachem 700 Test Methodologies Manual, Kodak Clinical Products, Rochester, N.Y., 1990.
- ↑ Kodak Ektachem 700 Operators Manual, Kodak Clinical Products, Rochester, N.Y., 1987.
- ↑ Package Insert, Kodak Ektachem Special Calibrators, Kodak Clinical Products, Rochester, N.Y., 1985.
- ↑ Package Insert, Bio-Rad Liquichek Controls, Bio-Rad ECS Division, Anaheim, CA., 1992.
- ↑ Lactic Acid, Plasma Laboratory Test Directory ARUP: http://www.aruplab.com/guides/ug/tests/0020045.jsp
- ↑ Panel of 10 tests Laboratory Test Directory ARUP: http://www.aruplab.com/guides/ug/tests/0099289.jsp
- ↑ 7.0 7.1 Puskarich MA et al. Prognostic value of incremental lactate elevations in emergency department patients with suspected infection. Acad Emerg Med 2012 Aug; 19:983 PMID: https://www.ncbi.nlm.nih.gov/pubmed/22905962