Alternatively, syringes containing powdered heparin specifically designed for arterial blood collection are commercially available. This process coats the inside of the syringe barrel and the needle hub. The sample should be collected into a heparinized syringe, which is usually just a syringe that has been filled with heparin and then emptied. Sample collection is usually performed with a 1- or 3-ml syringe with a 21-ga or smaller needle. But any large superficial artery may be used. Free-flowing lingual venous blood can sometimes be used to estimate arterial blood gas values in anesthetized animals when arterial blood is unobtainable.1 Common sites for arterial blood collection in dogs and cats include the dorsal pedal artery, femoral artery, or lingual artery. Arterial blood is preferred when assessing respiratory and metabolic status, but venous blood may be useful for the assessment of some metabolic disturbances such as those that occur during severe diarrhea, vomiting, and some toxin exposures. For those with the most severe increase (lactate >6.0 mmol/L), it is important that either point-of-care or laboratory-based methods be used for monitoring.Blood gas analysis begins with the collection of the sample. The results of this study suggest that laboratory and point-of-care blood gas analyzer lactate results are interchangeable so long as the lactate concentration is less then 6.0 mmol/L. normal and moderately raised lactate) but slightly lower results (compared with laboratory-based methods) above a lactate concentration of 6.0 mmol/L. Compared with all other methods, the dedicated point-of-care lactate analyzer reported slightly higher lactate results across the concentration range.īoth point-of-care blood gas analyzer methods showed excellent agreement with laboratory-based methods across the concentration range of 0.8-6.0 mmol/L (i.e. All three point-of-care methods, as well as the other plasma laboratory-based assay, showed good correlation (correlation coefficients r 2 all 0.99 or greater) when compared with this chosen reference method.īland-Altman plots revealed very close agreement between the two plasma methods across the full concentration range (1-14 mmol/L) of the 90 specimens. Immediately (within 5 minutes) after analysis, blood samples were centrifuged and the recovered plasma submitted for lactate analysis using the two laboratory-based methods.įor statistical analysis of results by the five methods, one of the laboratory-based plasma methods was chosen as the reference methodology. All analyses were complete within an hour of blood sampling. This is the issue addressed by a recently published study in which lactate results obtained by three whole-blood point-of-care methodologies (two blood gas analyzers and one dedicated lactate analyzer) were compared with those obtained using two laboratory-based plasma assays.Ī single anticoagulated blood sample from each of 90 intensive care patients was submitted for lactate measurement using the three different point-of-care analyzers. Traditionally, lactate has been measured on serum/plasma samples in the central laboratory, but modern blood gas and other point-of-care analyzers now provide the means for real-time monitoring of lactate on whole blood at the patient’s bedside.Īlthough these newer methods have been well validated, it remains unclear if results obtained at the point of care are interchangeable with those obtained in the central laboratory. Lactate measurement is important for diagnostic and prognostic assessment of the critically ill.
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