Epic Test Code LAB95 Lactic Acid
Performing Location(s)
BMC,CRH,LFH,OCH,FTT,FOX
Specimen Type
Plasma
Preferred Container
Gray top – Collection of a satisfactory specimen for lactate analysis requires special procedures to prevent changes in lactate while and after the specimen is drawn. The patient should be fasting and at complete rest. Blood is best collected without stasis (a tourniquet) in a container of sodium fluoride/potassium oxalate, followed by immediate chilling of the specimen and separation of the cells within 15 minutes
Blood Tube Draw Volume
Min 50% draw volume
Minimum Volume to Submit for Testing
0.5 mL Plasma
Transportation Needs
Immediate chilling and delivery of the specimen to the laboratory for prompt separation from cells is essential to ensure optimum specimen integrity. Separation from cells should occur within 15 minutes of collection. OUTREACH CENTERS: must send separated plasma frozen to ensure sample integrity.
Storage Requirements
Sample tubes should be centrifuged within 15 minutes of collection followed by transfer of the plasma to a labeled plastic, aliquot tube.
If testing cannot be performed immediately specimens should be aliquoted and frozen to preserve specimen integrity.
See Causes of Rejection for temperature requirements.
Causes for Rejection
Mislabeled or unlabeled specimen
Less than 50% draw for Vacutainer tubes
Specimen not received in gray top tube
Not on ice or frozen
Not received within 15 min of collection
Clotted
Hemolysis > 500 mg/dL HgB
Lipemia > 1000 mg/dL Trig
Bilirubin > 8 mg/dL Bili
Heparin
No Add-ons
Aliquoted Plasma > 14 days old Refigerated (Plasma tubes are routinely stored at the lab for only 3 days therefore, an add-on may not be possible after 3 days.)
Aliquoted Plasma > 8 hours old Room Temperature
Limitations
D-lactate is available as a send-out. Urine is the preferred specimen.
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.
This method is susceptible to cross reactivity from glycolate. Lactic acid may be elevated in the presence of ethylene glycol ingestion.
Reference Values
Specimen type | Population | Units | Critical Value | Reference Range |
Arterial Plasma | All Populations | mmol/L | > 3.9 | 0.5 - 1.6 |
Venous Plasma | All Populations | mmol/L | > 3.9 | 0.5 - 2.2 |
Reflex Testing
For Inpatients and Emergency Department patients only:
When the initial Lactic Acid is >2.0 mmol/L, a reflex order as a Sepsis Protocol Beaker test will be added to the sample number.
Days of Analysis
All
Available STAT
Yes
Additional Information
Patient Preparation:
Patient should not exercise prior to collection
The patient should be fasting and at complete rest.
Collect blood without a tourniquet into a gray top tube.
Do not collect blood frim ischemic limbs.
Follow appropriate nursing protocols for line draws.
Methodology
Beckman AU/Dx Series
CPT Code
83605
Last Updated
5-DEC-24 MS