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1. Lactate point-of-care testing for acidosis: Cross-comparison of two devices with routine laboratory results.

Author

van Horssen R, Schuurman TN, de Groot MJM, and Jakobs BS

Abstract

Objectives: Lactate is a major parameter in medical decision making. During labor, it is an indicator for fetal acidosis and immediate intervention. In the Emergency Department (ED), rapid analysis of lactate/blood gas is crucial for optimal patient care. Our objectives were to cross-compare-for the first time-two point-of-care testing (POCT) lactate devices with routine laboratory results using novel tight precision targets and evaluate different lactate cut-off concentrations to predict metabolic acidosis., Design and Methods: Blood samples from the delivery room ( n =66) and from the ED ( n =85) were analyzed on two POCT devices, the StatStrip-Lactate (Nova Biomedical) and the iSTAT-1 (CG4+ cassettes, Abbott), and compared to the routine laboratory analyzer (ABL-735, Radiometer). Lactate concentrations were cross-compared between these analyzers., Results: The StatStrip correlated well with the ABL-735 ( R =0.9737) and with the iSTAT-1 ( R =0.9774) for lactate in umbilical cord blood. Lactate concentrations in ED samples measured on the iSTAT-1 and ABL-735 showed a correlation coefficient of R =0.9953. Analytical imprecision was excellent for lactate and pH, while for pO 2 and pCO 2 the coefficient of variation was relatively high using the iSTAT-1., Conclusion: Both POCT devices showed adequate analytical performance to measure lactate. The StatStrip can indicate metabolic acidosis in 1 μl blood and will be implemented at the delivery room.

Published
2015
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2. Lactate point-of-care testing for acidosis: Cross-comparison of two devices with routine laboratory results

Author

Remco van Horssen, Teska N. Schuurman, Bernadette S. Jakobs, and Monique J.M. de Groot

Subjects
Fetal acidosis, Point-of-care testing, Coefficient of variation, Clinical Biochemistry, POCT, point-of-care testing, Umbilical cord, Blood gas, TEa, Total Allowable Error, lcsh:Chemistry, 03 medical and health sciences, 0302 clinical medicine, medicine, 030212 general & internal medicine, Acidosis, lcsh:R5-920, 030219 obstetrics & reproductive medicine, Radiological and Ultrasound Technology, business.industry, ED, Emergency Department, CV, coefficient of variation, Routine laboratory, Metabolic acidosis, Medical decision making, medicine.disease, CCU, Critical Care Unit, medicine.anatomical_structure, lcsh:QD1-999, Anesthesia, Lactate, medicine.symptom, SD, standard deviation, business, lcsh:Medicine (General), SEE, Standard Error of Estimate, Research Article, Biomedical engineering
Abstract

Objectives: Lactate is a major parameter in medical decision making. During labor, it is an indicator for fetal acidosis and immediate intervention. In the Emergency Department (ED), rapid analysis of lactate/blood gas is crucial for optimal patient care. Our objectives were to cross-compare-for the first time-two point-of-care testing (POCT) lactate devices with routine laboratory results using novel tight precision targets and evaluate different lactate cut-off concentrations to predict metabolic acidosis. Design and methods: Blood samples from the delivery room (n=66) and from the ED (n=85) were analyzed on two POCT devices, the StatStrip-Lactate (Nova Biomedical) and the iSTAT-1 (CG4+ cassettes, Abbott), and compared to the routine laboratory analyzer (ABL-735, Radiometer). Lactate concentrations were cross-compared between these analyzers. Results: The StatStrip correlated well with the ABL-735 (R=0.9737) and with the iSTAT-1 (R=0.9774) for lactate in umbilical cord blood. Lactate concentrations in ED samples measured on the iSTAT-1 and ABL-735 showed a correlation coefficient of R=0.9953. Analytical imprecision was excellent for lactate and pH, while for pO2 and pCO2 the coefficient of variation was relatively high using the iSTAT-1. Conclusion: Both POCT devices showed adequate analytical performance to measure lactate. The StatStrip can indicate metabolic acidosis in 1 μl blood and will be implemented at the delivery room. Keywords: Lactate, Point-of-care testing, Blood gas, Fetal acidosis

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