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Lab Manual for UCSF Clinical Laboratories

Lab Manual for SFGH

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LACTATE

Item Value
Available Stat? Yes
Test code LACT
Performed by? Chemistry
Sendout? no
Price range $$$
In House Availability Routine: 7 days;
STAT: 24 hours/ 7 days
Principle Lactate in the sample is oxidized by lactate oxidase to pyruvate and hydrogen peroxide. The hydrogen peroxide generated oxidizes the 4-aminoantipyrine chromogen system in a peroxidase-catalyzed reaction and results in a dye complex. The change in absorbance of the dye complex is proportional to the lactate concentration.
Interpretation Lactate is the end product of the anaerobic metabolism of glucose. The concentration in the blood is dependent on the rate of production in muscle cells and erythrocytes and the rate of metabolism in the liver. Lactic acidosis usually results from overproduction or under utilization of lactate. Elevated levels can occur as a result of tissue hypoxia, Diabetes mellitus, phenformin therapy, malignancies, glycogen storage disease, ethanol, methanol, or salicylate ingestion, or metabolic acidosis.

In patients with severe sepsis, lactate levels of greater than or equal to 2.0 mmol/L indicate increased risk for 28-day mortality (reference 5).
Container type gray top tube (Na fluoride tube) on ice or room temp if received within 30 mins of collection.
Amount to Collect 2 mL
Sample type Blood
Special instructions Deliver to Clinical Lab (2M) immediately in a cup of ice.

Draw the specimen when the patient is at rest without the use of a tourniquet or within 3 minutes of applying the tourniquet.
Normal range 0.5 - 2.2 mmol/L.
All values > 3.9 mmol/L (greater than or equal to 4.0 mmol/L) are considered critical values and are called to the physician or patient care unit immediately.
Interferences Improper specimen handling (specimen not on ice or delayed transport) can result in false elevations in lactate concentrations of 20 – 70%.
References 1. Olivia PB: AM J Med., 48:209-225, 1970

2. Renoe BW, McDonald, JM and Ladenson, JH: Clin. Chim. Acta. 103:91-100, 1980.

3. Sacks, DB: Carbohydrates, in Tietz Fundamentals of Clinical Chemistry, 5th ed., CA Burtis and ER Ashwood, eds. WB Saunders Co. Philadelphia, PA, pp 450-452, 2001.

4. Bayer(TM) Clinical Methods Lactate B01-4818-01 Advia 1650 Operator's Guide. PN 073-5001-09. Last accessed June 2003. Siemens Medical Solutions Diagnostics, Malvern, PA.

5. Mikkelsen et al. Crit Care Med 37(5):1670-77, 2009.
CPT coding 83605
Last Updated 10/22/2012 6:36:54 PM
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