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Epic Test Code LAB187 LACTIC ACID: Spinal Fluid (CSF)

Performing Location(s)

BMC

Specimen Type

Spinal Fluid

Preferred Container

Tube #1 of the Lumbar Puncture Tray is customarily used for Chemistry testing

Normal procedures for the collection of cerebrospinal fluid may be used for specimens to be analyzed to the LA method. Avoid hemolysis

Minimum Volume to Submit for Testing

0.5 mL CSF

  • Multiple test can be performed from this volume. For question please contact the lab at 547-3975.  

Storage Requirements

Deliver to laboratory immediately (within 1 hour) ON ICE.

If testing cannot be performed immediately, refrigerate the sample for up to 3 days or freeze for up to 1 month

Transportation Needs

Deliver specimen to the laboratory ON ICE within 1 hour of collection.

If not  possible see “storage requirements”

Causes for Rejection

Mislabeled or unlabeled specimen

Not transported on ice within 1 hour of collection

> 3 days Refrigerated after received in Laboratory

 

Limitations

CSF values are normally close to those found in blood but may change independently in central nervous system disorders.

Increases must be interpreted in light of the clinical setting and in concert with conventional parameters (glucose, protein, cell count, Gram stain, and culture).

Slight increases have been described with craniocerebral trauma, stroke, seizures, and brain tumor. Results from neurosurgical cases must be interpreted cautiously.

Intravenous injection of epinephrine, glucose, bicarbonate, or other infusions that modify the acid-base balance causes elevation in lactate (and also pyruvate) levels not necessarily related to hypoxia

Grossly hemolyzed samples will give increased LA results due to the presence of lactic acid in the red blood cells.

Reference Values

Fluid Type Units Reference Range Critical Value
All populations mmol/L 0.6 - 2.2 >5.0

 

Days of Analysis

All

Available STAT

Yes

Additional Information

A linear increase in CSF lactate in relation to lactate producing inflammatory cells with high levels at cell counts >350 uL has been noted. It is implied that increase in CSF lactate results from CSF pleocytosis.

Antimicrobial therapy given prior to collection of spinal fluid may decrease reliability of the usual diagnostic tests (Gram stain, culture, protein and glucose levels).

Equivocal results of tests in some instances of aseptic meningitis may lead to an erroneous diagnosis of bacterial etiology. The Gram stain may be negative in as many as 25% of culture proven bacterial meningitis.

Methodology

Beckman AU/Dx Series

CPT Code

83605

Last Updated

30-July-19