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

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• 作者：Remco van Horssen^a ; ^{r.horssen@elisabeth.nl" class="auth_mail" title="E-mail the corresponding author} ; Teska N. Schuurman^b ; Monique J.M. de Groot^a ; Bernadette S. Jakobs^a
• 关键词：POCT ; point-of-care testing ; ED ; Emergency Department ; CCU ; Critical Care Unit ; CV ; coefficient of variation ; SD ; standard deviation ; SEE ; Standard Error of Estimate ; TEa ; Total Allowable Error
• 刊名：Practical Laboratory Medicine
• 出版年：2016
• 出版时间：1 April 2016
• 年：2016
• 卷：4
• 期：Complete
• 页码：41-49
• 全文大小：1286 K

文摘

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.