1
|
Levy IH, Spittler AP, Santangelo KS, Sadar MJ. Comparison of two point of care lactate instruments in guinea pigs ( Cavia porcellus). J Exot Pet Med 2023; 46:7-11. [PMID: 38894854 PMCID: PMC11185414 DOI: 10.1053/j.jepm.2023.03.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/17/2023]
Abstract
Background Lactate measurements have been utilized as diagnostic and prognostic tools for a variety of veterinary species. Reference intervals for lactate have not been published or validated in guinea pigs. Methods Whole blood from 48 anesthetized laboratory guinea pigs (46 Dunkin Hartley [38 males, eight females]; two Strain 13 [two males]) was analyzed using two point of care instruments (iSTAT and Lactate Plus). There were two consecutive timepoints on the iSTAT (iSTAT time 1 and time 2) and three consecutive timepoints on the Lactate Plus (Lactate Plus time 1, time 2, and time 3). Results There was agreement with no constant or proportional bias between the two instruments compared at equivalent timepoints (iSTAT time 1 and Lactate Plus time 3) as determined by Bland-Altman (bias: -0.19; 95% LoA: -0.55 to 0.16) and Deming linear regression analyses (slope: 1.092, 95% confidence intervals (CI): -0.9 to 1.29; y-intercept: 0.09, 95% CI: -0.12 to 0.30). Reference intervals for iSTAT time 1 were 0.49 to 1.83 mmol/L and Lactate Plus time 1 were 0.60 to. 2.2 mmol/L. There was a significant increase in lactate values from iSTAT time 1 to iSTAT time 2 and from Lactate Plus time 1 to Lactate Plus time 3. Conclusions and Clinical Relevance This study found strong agreement between the point of care instruments. Reference intervals for lactate for both the iSTAT and Lactate Plus instruments were similar to canine and feline intervals. Analysis should occur within 5 minutes of sample collection. Future work should assess lactate as a prognostic indicator in guinea pigs.
Collapse
Affiliation(s)
- Ivana H. Levy
- College of Veterinary Medicine and Biomedical Sciences, James L. Voss Veterinary Teaching Hospital, Colorado State University, Fort Collins, CO, USA
| | - Alexa P. Spittler
- Department of Microbiology, Immunology, and Pathology, College of Veterinary Medicine and Biomedical Sciences, Colorado State University, Fort Collins, CO, USA
| | - Kelly S. Santangelo
- Department of Microbiology, Immunology, and Pathology, College of Veterinary Medicine and Biomedical Sciences, Colorado State University, Fort Collins, CO, USA
| | - Miranda J. Sadar
- Department of Clinical Sciences, College of Veterinary Medicine and Biomedical Sciences, Colorado State University, Fort Collins, CO, USA
| |
Collapse
|
2
|
Merkel J, Chinnadurai SK. Diagnostic Use of Lactate in Exotic Animals. Vet Clin North Am Exot Anim Pract 2022; 25:585-596. [PMID: 36122941 DOI: 10.1016/j.cvex.2022.05.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
Monitoring blood lactate concentrations with a handheld, point-of-care (POC) meter is an efficient and inexpensive method of monitoring critically ill or anesthetized exotic patients. Serial monitoring of lactate allows early recognition of hypoperfusion, allowing for prompt implementation of resuscitative efforts. Reference ranges for exotic animals are currently sparse and often gathered from field studies of wild animals. In the absence of reference ranges, extrapolations can be made regarding mammals and birds, but may be more difficult in reptiles and amphibians.
Collapse
Affiliation(s)
- Jane Merkel
- Department of Animal Health, Saint Louis Zoo, One Government Drive, St Louis, MO 63110, USA
| | - Sathya K Chinnadurai
- Department of Animal Health, Saint Louis Zoo, St Louis, MO 63110, USA; Chicago Zoological Society, Brookfield, IL 60513, USA.
| |
Collapse
|
3
|
Trenholme HN, Tynan B, Jackson M, Kerl M. Comparison of point-of-care NOVA CCX blood gas analyzer to laboratory analyzer in a population of healthy adult cats. J Vet Emerg Crit Care (San Antonio) 2022; 32:173-180. [PMID: 35166436 DOI: 10.1111/vec.13155] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2019] [Revised: 08/23/2020] [Accepted: 09/05/2020] [Indexed: 11/27/2022]
Abstract
OBJECTIVE To compare the level of agreement of measurement of analytes (sodium, chloride, potassium, urea nitrogen [UN], creatinine, glucose) in a population of healthy adult cats between the point-of-care (POC) analyzer and laboratory analyzer. To establish reference intervals for the POC analyzer in healthy adult cats. DESIGN Prospective observational study. SETTING University teaching hospital. ANIMALS Fifty-five cats were screened. Seven cats were excluded due to aggression that prohibited phlebotomy, and 1 cat was excluded due to prolonged restraint; 47 cats were enrolled. INTERVENTIONS None. MEASUREMENTS AND MAIN RESULTS In this patient population, reference intervals for the POC analyzer were calculated: sodium 145-157 mmol/L; chloride 116-124 mmol/L; potassium 3.4-5.5 mmol/L; UN 5.71-13.9 mmol/L (16-39 mg/dl); creatinine 74.3-189.2 mmol/L (0.84-2.14 mg/dl); and glucose 4-11.8 mmol/L (72-213 mg/dl). Comparison between the POC analyzer and laboratory analyzer using the Bland-Altman method was performed. The bias for each analyte is as follows: sodium 1.55 mmol/L; chloride 0.99 mmol/L; potassium 0.21 mmol/L; UN -0.25 mmol/L (-0.7 mg/dl); creatinine 9.73 mmol/L (0.11 mg/dl); and glucose 0.5 mmol/L (9.79 mg/dl). CONCLUSIONS Reference intervals for each analyte were similar to other chemistry analyzers. There was no significant difference between the POC and laboratory analyzers in analysis of UN, with a statistically significant difference observed with sodium, potassium, chloride, creatinine, and glucose. However, the values are likely not sufficiently different to alter initial clinical decisions regarding patient care.
Collapse
Affiliation(s)
- H Nicole Trenholme
- Department of Veterinary Medicine and Surgery, University of Missouri, Columbia, Missouri, USA.,Department of Veterinary Clinical Medicine, University of Illinois, 1008 W Hazelwood Drive, Urbana, Illinois, 61802, USA
| | - Beth Tynan
- Department of Veterinary Medicine and Surgery, University of Missouri, Columbia, Missouri, USA.,Charleston Veterinary Referral Center, Charleston, South Carolina, USA
| | - Mary Jackson
- Department of Veterinary Medicine and Surgery, University of Missouri, Columbia, Missouri, USA.,Animal Emergency and Critical Care Center of Brevard, Melbourne, Florida, USA
| | - Marie Kerl
- Department of Veterinary Medicine and Surgery, University of Missouri, Columbia, Missouri, USA.,VCA Inc., Los Angeles, California, USA
| |
Collapse
|
4
|
LACTIC ACIDOSIS INDUCED BY MANUAL RESTRAINT FOR HEALTH EVALUATION AND COMPARISON OF TWO POINT-OF-CARE ANALYZERS IN HEALTHY LOGGERHEAD SEA TURTLES ( CARETTA CARETTA). J Zoo Wildl Med 2022; 52:1195-1204. [PMID: 34998289 DOI: 10.1638/2021-0029] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/07/2021] [Indexed: 11/21/2022] Open
Abstract
Sea turtles are often restrained manually for brief periods during veterinary evaluation and care in rescue, rehabilitation, research, and aquarium settings. Blood gas values and lactate are routinely evaluated during triage of sea turtles, and lactate clearance is of prognostic significance in cold-stunned individuals. Although increases in blood lactate have been associated with muscle exertion, experimental forced submergence, trawl and pound net capture, and general anesthesia, changes in blood lactate associated with short periods of manual restraint have not been evaluated. Venous blood gas and lactate values were tested in 16 juvenile loggerhead sea turtles (Caretta caretta) before and after manual restraint for a 15-min routine veterinary examination. The agreement of blood lactate values between two point-of care analyzers (i-STAT and Lactate Plus) was also compared. Blood pH and bicarbonate (HCO3-) decreased significantly (P < 0.001), and partial pressure of carbon dioxide (pCO2) increased significantly (P < 0.0001) after 15 min. Lactate increased significantly between time points for both analyzers (P < 0.0001). Linear regression analysis showed excellent correlation for lactate measurements obtained on both analyzers (r = 0.998). The mean difference in lactate concentrations between the analyzers was statistically significant, indicating that the methods cannot be used interchangeably (P < 0.0001). Deming regression and Bland-Altman plots identified a slight negative proportional bias for lactate measurement by the Lactate Plus compared with the i-STAT. These results suggest that clinicians should evaluate blood gas values and lactate at the beginning of health evaluations and interpret serial lactate values in sea turtles with caution, because even short periods of manual restraint can induce lactic acidosis and considerably influence these values.
Collapse
|
5
|
Acierno MJ, Hirsch A, Dedeaux A. Evaluation of the agreement between a point-of-care lactate meter and a handheld laboratory analyzer in cats treated in emergency practice. J Vet Emerg Crit Care (San Antonio) 2019; 30:50-53. [PMID: 31845516 DOI: 10.1111/vec.12911] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2017] [Revised: 03/23/2018] [Accepted: 04/17/2018] [Indexed: 11/29/2022]
Abstract
OBJECTIVE The purpose of this study was to determine if there was agreement between a new point-of-care (POC) lactate analyzer and a handheld laboratory analyzer when measuring blood lactate concentration in cats. DESIGN Prospective observational study. SETTING University veterinary teaching hospital. ANIMALS Fifty-four cats that presented to an emergency service. INTERVENTIONS None. MEASUREMENTS AND MAIN RESULTS Lactate concentrations as measured by the handheld laboratory analyzer ranged from 0.3 to 15.4 mmol/L. Agreement analysis of the handheld laboratory analyzer and the POC lactate meter demonstrated a bias, -0.06 and limits of agreement ranging from -0.87 to 0.99 mmol/L. Regression analysis demonstrated a coefficient of determination (R2 ) of 0.98. CONCLUSION Results of the present study indicate that the POC lactate meter provided results that are in agreement with a handheld laboratory analyzer when measuring lactate in clinically ill patients.
Collapse
Affiliation(s)
- Mark J Acierno
- Department of Medicine, School of Veterinary Medicine, Midwestern University, Glendale, AZ
| | - Aubrey Hirsch
- Department of Clinical Sciences, School of Veterinary Medicine, Louisiana State University, Baton Rouge, LA
| | - Andrea Dedeaux
- Department of Clinical Sciences, School of Veterinary Medicine, Louisiana State University, Baton Rouge, LA
| |
Collapse
|
6
|
Rosenstein PG, Tennent-Brown BS, Hughes D. Clinical use of plasma lactate concentration. Part 1: Physiology, pathophysiology, and measurement. J Vet Emerg Crit Care (San Antonio) 2018. [PMID: 29533512 DOI: 10.1111/vec.12708] [Citation(s) in RCA: 32] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
OBJECTIVE To review the current literature with respect to the physiology, pathophysiology, and measurement of lactate. DATA SOURCES Data were sourced from veterinary and human clinical trials, retrospective studies, experimental studies, and review articles. Articles were retrieved without date restrictions and were sourced primarily via PubMed, Scopus, and CAB Abstracts as well as by manual selection. HUMAN AND VETERINARY DATA SYNTHESIS Lactate is an important energy storage molecule, the production of which preserves cellular energy production and mitigates the acidosis from ATP hydrolysis. Although the most common cause of hyperlactatemia is inadequate tissue oxygen delivery, hyperlactatemia can, and does occur in the face of apparently adequate oxygen supply. At a cellular level, the pathogenesis of hyperlactatemia varies widely depending on the underlying cause. Microcirculatory dysfunction, mitochondrial dysfunction, and epinephrine-mediated stimulation of Na+ -K+ -ATPase pumps are likely important contributors to hyperlactatemia in critically ill patients. Ultimately, hyperlactatemia is a marker of altered cellular bioenergetics. CONCLUSION The etiology of hyperlactatemia is complex and multifactorial. Understanding the relevant pathophysiology is helpful when characterizing hyperlactatemia in clinical patients.
Collapse
Affiliation(s)
- Patricia G Rosenstein
- Department of Veterinary Clinical Sciences, Faculty of Veterinary and Agricultural Sciences, University of Melbourne, Werribee, Victoria, Australia
| | - Brett S Tennent-Brown
- Department of Veterinary Clinical Sciences, Faculty of Veterinary and Agricultural Sciences, University of Melbourne, Werribee, Victoria, Australia
| | - Dez Hughes
- Department of Veterinary Clinical Sciences, Faculty of Veterinary and Agricultural Sciences, University of Melbourne, Werribee, Victoria, Australia
| |
Collapse
|
7
|
Kohen CJ, Hopper K, Kass PH, Epstein SE. Retrospective evaluation of the prognostic utility of plasma lactate concentration, base deficit, pH, and anion gap in canine and feline emergency patients. J Vet Emerg Crit Care (San Antonio) 2017; 28:54-61. [DOI: 10.1111/vec.12676] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2015] [Revised: 04/07/2016] [Accepted: 04/27/2016] [Indexed: 11/28/2022]
Affiliation(s)
- Casey J. Kohen
- William R. Pritchard Veterinary Medical Teaching Hospital; School of Veterinary Medicine; University of California at Davis; Davis CA 95616
| | - Kate Hopper
- Departments of Veterinary Surgical and Radiological Sciences; School of Veterinary Medicine; University of California at Davis; Davis CA 95616
| | - Philip H. Kass
- Population Health and Reproduction; School of Veterinary Medicine; University of California at Davis; Davis CA 95616
| | - Steven E. Epstein
- Departments of Veterinary Surgical and Radiological Sciences; School of Veterinary Medicine; University of California at Davis; Davis CA 95616
| |
Collapse
|
8
|
Cole GC, Tordiffe ASW, Steenkamp G. Assessment of a portable lactate meter for field use in the white rhinoceros (<i>Ceratotherium simum</i>). ACTA ACUST UNITED AC 2017; 84:e1-e10. [PMID: 29227129 PMCID: PMC8552300 DOI: 10.4102/ojvr.v84i1.1399] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2016] [Revised: 07/23/2017] [Accepted: 07/25/2017] [Indexed: 11/13/2022]
Abstract
Blood lactate is a predictor of mortality in critically ill humans and animals. Handheld lactate meters have the potential to be used in the field to evaluate the condition of severely injured rhinoceroses but have not been compared with laboratory-based methods. Agreement between a handheld lactate meter and a laboratory method was assessed, as was the stability of rhino blood lactate in the anticoagulant sodium fluoride/potassium oxalate (fluoride/oxalate). Blood samples were obtained from 53 white rhinos that had been immobilised for management reasons. Lactate was measured by means of a handheld meter using whole blood in heparin (WBHEP), whole blood in fluoride/oxalate (WBFO) and fluoride/oxalate plasma (PFO). Results were recorded in both blood (BL) and plasma (PL) modes and compared to an established laboratory method for measuring plasma lactate. To assess the stability of lactate over time, blood lactate in fluoride/oxalate was measured on the handheld meter at intervals for up to 91 h. Agreement was best using WBFO in PL mode, with small bias (−0.16), tight 95% limits of agreement (LOA) (−1.46, 1.14) and a Pc (95% CI) of 0.97 (0.92, 0.99). The agreement was improved for all sample types when using the PL mode compared to the blood lactate (BL) mode. Blood lactate was stable in fluoride/oxalate for 91 h, with a mean change from baseline of 0.15 (−0.178, 0.478) mmol/L (mean, 95% CI). The handheld meter was found to be suitable for field use in white rhinos but provided more reliable results with the device in PL mode. Furthermore, rhino blood lactate was found to be stable in fluoride/oxalate for as long as 3 days.
Collapse
Affiliation(s)
- Georgina C Cole
- Department of Companion Animal Clinical Studies, University of Pretoria.
| | | | | |
Collapse
|
9
|
EVALUATION OF THE EFFECTS OF STERNAL VERSUS LATERAL RECUMBENCY ON TRENDS OF SELECTED PHYSIOLOGIC PARAMETERS DURING ISOFLURANE ANESTHESIA IN ZOO-HOUSED BLACK-TAILED PRAIRIE DOGS (CYNOMYS LUDOVICIANUS). J Zoo Wildl Med 2017; 48:388-393. [PMID: 28749308 DOI: 10.1638/2016-0192r2.1] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
Isoflurane gas anesthesia is often used for immobilization of prairie dogs in field studies, laboratory research, and veterinary clinical purposes. The goals of this prospective study were to evaluate the effects of sternal versus right lateral recumbency on trends of selected physiologic parameters during isoflurane anesthesia in black-tailed prairie dogs ( Cynomys ludovicianus ). Fourteen adult, zoo-housed black-tailed prairie dogs were tested during the study. Animals were anesthetized using isoflurane and randomly placed in either sternal or right lateral recumbency to evaluate changes in trends of physiologic parameters, measured selectively every 30 min throughout a 60-min anesthesia period. Results were analyzed using linear mixed modeling. Right lateral recumbency resulted in a decrease in anion gap of about 4.6 mEq/L (95% confidence interval [95% CI]: 3.1-6.0, P < 0.001), whereas sternal recumbency resulted in a lower decrease of 2.1 mEq/L (95% CI: 0.7-3.6, P = 0.02). However, the absolute values at the beginning and at the end of the anesthesia time were not significantly different between the right lateral and sternal recumbency (all P > 0.57). Body position did not have any effect on any other variables, and most of the observed physiologic changes were due to the duration of anesthesia. Our results indicate no significant effect on trends of selected physiologic parameters between sternal recumbency and right lateral recumbency during 1 hr of isoflurane anesthesia in black-tailed prairie dogs.
Collapse
|
10
|
Bachmann K, Kutter APN, Schefer RJ, Marly-Voquer C, Sigrist N. Determination of reference intervals and comparison of venous blood gas parameters using standard and non-standard collection methods in 24 cats. J Feline Med Surg 2017; 19:831-840. [PMID: 27542821 PMCID: PMC11104123 DOI: 10.1177/1098612x16663269] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/27/2024]
Abstract
Objectives The aim of this study was to determine in-house reference intervals (RIs) for venous blood analysis with the RAPIDPoint 500 blood gas analyser using blood gas syringes (BGSs) and to determine whether immediate analysis of venous blood collected into lithium heparin (LH) tubes can replace anaerobic blood sampling into BGSs. Methods Venous blood was collected from 24 healthy cats and directly transferred into a BGS and an LH tube. The BGS was immediately analysed on the RAPIDPoint 500 followed by the LH tube. The BGSs and LH tubes were compared using paired t-test or Wilcoxon matched-pairs signed-rank test, Bland-Altman and Passing-Bablok analysis. To assess clinical relevance, bias or percentage bias between BGSs and LH tubes was compared with the allowable total error (TEa) recommended for the respective parameter. Results Based on the values obtained from the BGSs, RIs were calculated for the evaluated parameters, including blood gases, electrolytes, glucose and lactate. Values derived from LH tubes showed no significant difference for standard bicarbonate, whole blood base excess, haematocrit, total haemoglobin, sodium, potassium, chloride, glucose and lactate, while pH, partial pressure of carbon dioxide and oxygen, actual bicarbonate, extracellular base excess, ionised calcium and anion gap were significantly different to the samples collected in BGSs ( P <0.05). Furthermore, pH, partial pressure of carbon dioxide and oxygen, extracellular base excess, ionised calcium and anion gap exceeded the recommended TEa. Conclusions and relevance Assessment of actual and standard bicarbonate, whole blood base excess, haematocrit, total haemoglobin, sodium, potassium, chloride, glucose and lactate can be made based on blood collected in LH tubes and analysed within 5 mins. For pH, partial pressure of carbon dioxide and oxygen, extracellular base excess, anion gap and ionised calcium the clinically relevant alterations have to be considered if analysed in LH tubes.
Collapse
Affiliation(s)
- Karin Bachmann
- Department for Small Animals, Vetsuisse Faculty, University of Zurich, Zurich, Switzerland
| | - Annette PN Kutter
- Section of Anaesthesiology, Equine Department, Vetsuisse Faculty, University of Zurich, Zurich, Switzerland
| | - Rahel Jud Schefer
- Department for Small Animals, Vetsuisse Faculty, University of Zurich, Zurich, Switzerland
| | - Charlotte Marly-Voquer
- Section of Anaesthesiology, Equine Department, Vetsuisse Faculty, University of Zurich, Zurich, Switzerland
| | - Nadja Sigrist
- Department for Small Animals, Vetsuisse Faculty, University of Zurich, Zurich, Switzerland
| |
Collapse
|
11
|
Gillespie Í, Rosenstein PG, Hughes D. Update: Clinical Use of Plasma Lactate. Vet Clin North Am Small Anim Pract 2016; 47:325-342. [PMID: 27914760 DOI: 10.1016/j.cvsm.2016.10.011] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
Lactate is an essential, versatile metabolic fuel in cellular bioenergetics. In human emergency and critical care, lactate is used as a biomarker and therapeutic endpoint and evidence is growing in veterinary medicine supporting its clinical utility. Lactate production is a protective response providing ongoing cellular energy during tissue hypoperfusion or hypoxia and mitigating acidosis. Hence, hyperlactatemia is closely associated with disease severity but it is an epiphenomenon as the body attempts to protect itself. This article reviews lactate biochemistry, kinetics, pathophysiology, some practical aspects of measuring lactate, as well as its use in diagnosis, prognosis, and monitoring.
Collapse
Affiliation(s)
- Íde Gillespie
- Emergency and Critical Care Service, UVet Werribee Animal Hospital, Faculty of Veterinary and Agricultural Sciences, University of Melbourne, 250 Princes Highway, Werribee, Melbourne, Victoria 3030, Australia
| | - Patricia G Rosenstein
- Emergency and Critical Care Service, UVet Werribee Animal Hospital, Faculty of Veterinary and Agricultural Sciences, University of Melbourne, 250 Princes Highway, Werribee, Melbourne, Victoria 3030, Australia
| | - Dez Hughes
- Emergency and Critical Care Service, UVet Werribee Animal Hospital, Faculty of Veterinary and Agricultural Sciences, University of Melbourne, 250 Princes Highway, Werribee, Melbourne, Victoria 3030, Australia.
| |
Collapse
|
12
|
Di Mauro FM, Schoeffler GL. Point of Care Measurement of Lactate. Top Companion Anim Med 2016; 31:35-43. [PMID: 27451047 DOI: 10.1053/j.tcam.2016.05.004] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2016] [Accepted: 05/19/2016] [Indexed: 01/25/2023]
Abstract
Lactate is generated as a consequence of anaerobic glycolysis by all tissues of the body. Increased l-lactate, the isoform produced by most mammals, reflects increased anaerobic metabolism secondary to tissue hypoperfusion or tissue hypoxia in most clinical situations, and is called type A lactic acidosis. The utility of lactate measurement and serial lactate monitoring in veterinary patients has been demonstrated in multiple studies. Blood lactate concentration is significantly elevated in many disease processes including septic peritonitis, immune-mediated hemolytic anemia, Babesiosis, trauma, gastric dilation and volvulus, and intracranial disease. Lactate clearance can be used to assess response to fluid therapy, cardiovascular therapeutics, and blood product transfusion in patients affected by type A lactic acidosis. Lactate concentration in peritoneal, pericardial, and synovial fluid can also be used as a diagnostic tool. Point of care analyzers such as the Lactate Pro, Lactate Scout, Accutrend, iSTAT, and Lactate Plus have been shown to be accurate lactate measurement instruments in small animal patients.
Collapse
Affiliation(s)
| | - Gretchen Lee Schoeffler
- Department of Clinical Sciences, College of Veterinary Medicine, Cornell University, Ithaca, NY, USA.
| |
Collapse
|