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HelpTest Code LAB3574 Lactic Acid Blood
Clinical System Name
Lactic Acid Blood
Synonyms
LAB3574
LACT
Lactate
Lactate, Syringe
Lactic Acid, Syringe
Sample Requirements
Specimen: Whole Blood
Container(s): Heparinized Syringe, Dark Green/Sodium Heparin*, Lt. Grey Sodium Fluoride, capillary blood gas tubes
Required Vol: 2 mL
Minimum Vol: 0.5 mL (Syringe only) or 2 capillary blood gas tubes (EPOC capillary tubes are only acceptable at Bellevue, South, or North clinics).
Notes: Method is affected by exposure to RBC's (longer than 15 minutes), drawing blood with stasis, and by oxygen depletion (exercise, hypoxia, crying). Do not use tourniquet for more than 30 seconds at a time and do not allow patient to flex or clench fist. For hemodilution patients, note the collection site.
If syringe sample is drawn, sample volume can be shared with blood gas, ionized calcium, =lytes, and =glu.
Remove air bubbles from Heparinized Syringe immediately after collection. Capillary blood gas tubes must be filled completely and mixed thoroughly to dissolve and disperse the heparin. Deliver to Lab immediately, avoid air bubbles. Ideally, whole blood specimens should be analyzed within 15 minutes of blood draw.
*For 4.0 mL Dark Green/Sodium Heparin tubes, less than 1/2 full will be rejected. Do not remove vacutainer top to fill tube.
Place specimen in outside pocket of a pre-filled biohazard bag of ice, then put into a separate biohazard bag for transport.
If collected at Bellevue, South, or North Clinic only - do not place on ice.
Processing Instructions
Reject due to: Green Top or Gray Top not received on ice, age of specimen, wrong specimen container
Spin: N
Aliquot: N
Temp: 2-8oC
Storage location: Core Chemistry Refrigerator
Off-site collection: READ "COMMENTS/NOTES" BEFORE COLLECTION!* Do not use a tourniquet for more than 30 seconds at a time and do not have patient clench fist. Avoid hemolysis. PROCESS IMMEDIATELY. Spin blood within 15 minutes of draw, remove plasma and freeze in a plastic tube at -20°C. Ship on dry ice. Plasma must be removed from red blood cells within 15 minutes for an accurate lactic acid level.
*Capillary blood gas tubes are not acceptable for offsite collection.
Stability
| Specimen Type | Temperature | Time |
|---|---|---|
| Whole Blood (Syringe or capillary) | RT |
≤ 15 min ≤ 10 min at Bellevue, South, North |
| Whole Blood (Syringe or capillary) | 0-4oC |
≤ 30 min |
| Plasma* | RT |
≤ 8 h |
| Plasma* | 2-8 C |
≤ 14 d |
| Plasma* | -20 C or -70 C |
≤ 30 d |
*For sample collected in a Green Top or Gray Top, plasma must be removed from red blood cells within 15 minutes for an accurate lactic acid level.
Availability
| STAT | Performed | TAT |
|---|---|---|
| Y | 24/7 | 1 h |
Performing Laboratory
Seattle Children's Laboratory
Department
Department: Core Rapidpoint/Chemistry
Phone Number: 206-987-2617 (Client Services)
CPT Codes
83605
Methodology
Whole blood Method: Amperometric by Siemens Rapid Point 500
Analytical Volume: 0.2mL
Plasma Method: Colorimetric by Vitros 4600
Analytical Volume: 0.02 mL plasma + 0.03 mL dead space
Reference Range
0.5 - 2.2 mMol/L
Description
The concentration of lactate in the blood is dependent on the rate of production in muscle cells and erythrocytes and the rate of metabolism in the liver. Lactic acidosis usually results from overproduction or underutilization of lactate. Elevated lactate levels can occur as a result of tissue hypoxia, diabetes mellitus, phenformin therapy, malignancies, glycogen storage disease, metabolic acidosis, and ethanol, methanol, or salicylate ingestion.