Lab Information Manual

Laboratory:

Clinical Biochemistry (POC (Point of Care) TEST)

Test Name:

Lactate - epoc - (B)

Test Code: LB

Clinical Information:

Description: Lactate is a by-product of anerobic metabolism and is indicative of tissue hypo-perfusion. Common causes for increased blood lactate include conditions such as shock, pneumonia, sepsis and congestive heart failure. Lactic acidosis may also occur in kidney failure and leukemia.

Test Indications: Diagnosis and monitoring of patients with lactic acidosis.

Surviving Sepsis (2021) guidelines recommend repeating lactate testing 6 hours after initial assessment, if the first lactate level is >2.0 mmol/L and the patient exhibits 2 or more SIRS criteria. Subsequent monitoring may occur once per day to evaluate response to treatment.

Reference: Critical Care Medicine. 49(11): p e1063-e1143, November 2021.

Collection Devices:

Preferred Device:	1 - Li Heparin, NO GEL 4.0 mL Tube(s) - Full Tube Collection Li Heparin, NO GEL 4.0 mL Tube(s) - Full Tube Collection Manufacturer: BD (Becton Dickinson) Catalogue #: 367884
Alternate Device:	1 - Balanced Heparin Blood Gas Syringe (AT LEAST HALF FULL) No Image Available Balanced Heparin Blood Gas Syringe (AT LEAST HALF FULL) Manufacturer: Catalogue #:

Capillary specimens must be collected in a balanced heparin capillary tube (FULL collection), capped, mixed, and tested within 5 minutes of collection.

Specimen Required:

Whole Blood: 4.0 mL

Pediatric Whole Blood: 0.1 mL

Collection Information: Avoid using prolonged tourniquet application (>1 minute) during phlebotomy.

Evacuated blood tubes must be FULL to maintain specimen stability. Specimens must remain capped until tested to avoid contamination with air.

Rejection criteria: clots, underfilled tube, leaking specimens, and specimens not received within 10 minutes of collection.

Capillary samples must be tested at the bedside, within 5 minutes.

Specimen Stability:

Ambient: 30 minutes (syringe); 10 minutes (vacutainer); 5 minutes (capillary)

Refrigerated: DO NOT REFRIGERATE

Frozen: DO NOT FREEZE

Do not submit specimens on ice.

Referral:

Only available at sites which perform epoc testing on-site.

Requisition:

_SH Hospital Biochemistry Hematology Non Winnipeg Brandon (R250-10-91)

Reference Values:

Reference Intervals: 0.9 – 2.4 mmol/L

Critical Values: ≥ 5.0 mmol/L

Method of Analysis: Amperometric determination using lactate oxidase

Siemens epoc® Blood Analysis System, BGEM test card

Availability:

Daily or Stat