Lactate for Sepsis Protocol


Sunquest Code:LACTS  
Epic Code:LAB7086Epic Name:Lactate for Sepsis Protocol
Synonyms:Lactic Acid
Methodology:Lactate electrode
Turnaround Time:Performed and reported 24 hours/day.


Collection Instructions

Specimen:Blood.
Optimal Volume:1 mL
Minimum\Peds Volume:0.2 mL
Container:Dry heparin syringe (Capillary (lithium heparin) gas tube, Green (lithium heparin) on ICE)
Collection Instructions:Collect without the use of a tourniquet or within 3 minutes of applying the tourniquet, but before releasing the tourniquet. Do not allow the patient to clench/uncleanch hand; this builds up lactic acid. Deliver to lab immediately.
Causes for Rejection:Moderate hemolysis.
Contraindications:Lack of acidosis is not a contraindication for this test.


Processing and Shipping

Specimen Processing:Analyze whole blood as soon as possible - within 15 minutes at room temp, 60 minutes on ice.  If transport is required, centrifuge (ideally within 15 min) at refrigerated temperature. Aliquot 0.2 mL, 0.1 mL minimum. Store on ice up to 24 hours; otherwise freeze immediately.
Shipping Instructions:Ship on dry ice.
Stability:Heparinized plasma is acceptable; however, the following precautions must be rigidly adhered to in order to retard glycolysis:
  1. collect on ice
  2. transport immediately
  3. centrifuge within 15 minutes of collection to avoid metabolism of glucose to lactate
  4. separate the plasma immediately and store on ice until analysis.
 
Test Performed at or Referral Lab Chemistry  (Fairview Range - FRMC, UMMC-East Bank, Fairview Lakes - FLMC, Fairview Ridges - FRH, Fairview Northland - FNMC, Fairview Southdale - FSH, UMMC/UMMCH-West Bank, UMMC NICU, Grand Itasca GICH)


Interpretive

Critical Range:Greater than 3.9 mmol/L (Significant Range: 2.1-3.9 mmol/L)
Reference Range:0.7-2.0 mmol/L
Use:Identify lactic acidosis which characteristically presents as an increased anion gap metabolic acidosis.


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