Measuring Lactate: And the Winner Is…
Lactate, a natural byproduct of anaerobic metabolism, increases in the blood following tissue hypoxia; accurate measurement of plasma lactate levels could provide information regarding prognosis and treatment responses for animals in critical care. Point-of-care, portable, lactate-measuring devices that are cost effective and accurate would prove useful. This study compares 2 portable lactate analyzers with a reference laboratory (a previously accepted method for lactate measurement).
Device A, previously shown to be accurate and cost effective, has been used mainly in human and equine patients. Device B has been used mainly in canine patients, but is costly to run, as a full blood gas panel is typically required each time. Eighty-five samples from 49 dog breeds including both hemodynamically stable and unstable patients were submitted for analysis using all 3 methods: device A, device B, and a reference laboratory. Both devices showed good agreement with reference laboratory when detecting significant elevations in plasma lactate levels; however, device B had better agreement. Device A requires a specific sample type and size to avoid error, potentially accounting for varying results between methods. The devices should not be used interchangeably.
CommentaryWhile point-of-care testing is convenient, accuracy is also critical, as these test results are used not only for directing treatment but often for making diagnoses and prognosticating outcomes. Lactate has become a common point-of-care test in veterinary medicine and has been studied as a prognostic indicator in illness (eg, gastric dilation-volvulus). It can help assess response to fluid therapy and diagnose such diseases as septic peritonitis. Results should be interpreted with caution, not only with one specific analyzer, but also when comparing results from different analyzers while interpreting therapeutic response.—Garret Pachtinger, VMD, DACVECC
SourceComparison of two portable lactate meters in dogs. Karagiannis MH, Mann FA, Madsen RW, et al. JAAHA 49:8-15, 2013.