Lactate, Whole Blood


Sunquest Code:LACTW  
Epic Code:LAB730Epic Name:Lactic Acid Whole Blood
Synonyms:Lactic Acid; Lactate for Lactate for Sepsis Protocol
Methodology:Lactate electrode
St. Johns/St Joseph/ Woodwinds: Lactic acid to pyruvate
Turnaround Time:Performed and reported 24 hours/day.


Collection Instructions

Specimen:Blood
Optimal Volume:1 mL
Minimum\Peds Volume:0.2 mL
Container:St Johns/St Joseph/Woodwinds-Green (lithium heparin, no gel), Dry heparin syringe
[Alternate Containers: 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 patient to clench/unclench hand; this builds up lactic acid. Deliver to laboratory 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  (Range, UMMC-East Bank, Lakes, Ridges, Northland, Southdale, UMMC/UMMCH-West Bank, UMMC NICU, M Health Clinic and Surgery Center, Grand Itasca, St. Joseph's, St. John's, Woodwinds)


Interpretive

Critical Range:Greater than 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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