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Epic Test Code LAB95 Lactic Acid

Important Note

Specimens collected on the MIBH Campus use Nova Prime Plus as primary method for Lactic Acid. Refer to Lactic Acid – NovaBio (Lab9995) for details.

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

7-Jun-23 BHD