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Lactic Acid, Whole Blood (Arterial or Venous)

Lactate

Test Codes

Arterial: EPIC: LAB6965, LART1, Venous: EPIC: LAB5348, LAW

Department

Chemistry

Instructions

Whole Blood Lactic Acid specimens should ONLY be collected at the Canton, Dearborn, Farmington Hills, Grosse Pointe, Royal Oak, Taylor, Trenton, Troy, or Wayne Hospital Campuses. Specimens should NOT be collected at any other Beaumont Laboratory drawsite, nursing home or Outreach office. 

Specimen Collection Criteria

Collect: Venous or arterial specimen, as described below:

Whole Blood Venous Lactic Acid:

• One 1 mL or 3 mL plastic blood gas syringe containing dry heparin.
• One Green-top Lithium or Sodium Heparin tube is acceptable. (Minimum: 0.5 mL)
• Specimen must be transported immediately to the Laboratory, on ice.

Whole Blood Arterial Lactic Acid:

• One 1 mL or 3 mL blood gas plastic syringe containing dry heparin.
• Specimen must be transported immediately to the Laboratory, on ice. See Blood Gas Procedure below.
• NOTE: Blood gas syringe specimens should ONLY be collected at the Canton, Dearborn, Farmington Hills, Grosse Pointe, Royal Oak, Taylor, Trenton, Troy or Wayne Hospital Campuses. Specimens should NOT be collected at any other Beaumont Laboratory drawsite, nursing home or Outreach office.

Collection Procedure for Blood Gas Syringes ONLY:

• NOTE: Blood gas syringe specimens should ONLY be collected at the Canton, Dearborn, Farmington Hills, Grosse Pointe, Royal Oak, Taylor, Trenton, Troy or Wayne Hospital Campuses. Specimens should NOT be collected at any other Beaumont Laboratory drawsite, nursing home or Outreach office.
• A 1 mL or 3 mL plastic syringe containing dry heparin is usually used to collect the specimen.
• At least 1-2 mL (0.3 mL for pediatric patients) of blood is needed to ensure proper assay.
• Arterial specimens are collected by a physician, nurse, or respiratory therapist.
• For specimens collected by syringe, any air bubbles present in the syringe must be immediately expelled, the needle removed, and the syringe tightly capped. The syringe is rolled between the palms of the hands to ensure mixing.
  • NOTE: The Radiometer safePico Self-fill^TM syringe has a metal ball to ensure homogeneous mixing when the syringe is rolled between the palms of the hands.
• Characterization of oxygen enrichment, at the time of arterial puncture, is required. This may be expressed as FiO2 fractional inspired oxygen concentration provided (e.g., 0.50), FiO2% (e.g., 50%), room air, or nasal cannula flow rate in liters per minute. The FiO2 must be noted on the requisition or entered as part of the electronic order for any arterial blood gas specimens. It is not possible to fully evaluate arterial blood gas results without knowledge of the oxygen concentration or nasal flow rate being delivered to a patient at the time of blood draw.
• The specimen must be properly labeled.
• Place on wet ice for transport. Ice and Specimen must be kept separated.
  • Suggested: Place specimen in front pocket of the biohazard bag. Place ice in zip lock section of biohazard bag.
• The specimen must be transported immediately to the Royal Oak STAT Lab, or the appropriate Chemistry Laboratory.

Rejection Criteria

Moderate to grossly hemolyzed specimens.

Specimens not collected on ice and processed as indicated.

Inpatient Specimen Preparation

The specimen must be transported STAT, on wet ice, to the STAT Laboratory (Royal Oak) or to the Chemistry Laboratories. 

In-Lab Processing

Heparin tubes: Deliver immediately to the appropriate testing station.
Blood Gas specimens: Immediately analyze the whole blood, heparinized, iced specimen upon receipt. 

Storage

Specimen Stability for Testing:

Dark Green-top Heparin Tubes
Room Temperature (20-26°C or 68-78.8°F): Unacceptable
Refrigerated (2-8°C or 36-46°F): 1 hour
Frozen (-20°C/-4°F or below): Unacceptable

Blood Gas Syringes
Room Temperature (20-26°C or 68-78.8°F): Unacceptable
Refrigerated (2-8°C or 36-46°F): 1 hour
Frozen (-20°C/-4°F or below): Unacceptable

Specimen Storage in Department Prior to Disposal:

Dark Green-top tubes: Refrigerated (2-8°C or 36-46°F): 7 days
Blood Gases: Specimens are disposed within 8 hours of testing.

Laboratory

Canton Laboratory
Dearborn Chemistry Laboratory
Farmington Hills Chemistry Laboratory 
Grosse Pointe Chemistry Laboratory
Livonia Main Laboratory
Lenox Main Laboratory
Royal Oak STAT Laboratory
Troy Chemistry Laboratory
Taylor Chemistry Laboratory
Trenton Chemistry Laboratory
Wayne Chemistry Laboratory 

Performed

Sunday – Saturday, 24 hours a day.
Routine results available within 4 hours.
STAT results available within 1 hour after receipt in the Laboratory.

Reference Range

Arterial: 0.0-1.3 mmol/L.
Venous: 0.5-2.0 mmol/L.

Test Methodology

Enzymatic.

Interpretation

Lactate is an end-product of glycolysis arising mainly in muscle, brain and RBC's. Increased levels may reflect increased rates of production and/or decreased clearance rates (by liver and kidney). Increased lactate production occurs during episodes of tissue hypoxia and anaerobic metabolism. Blood cells rapidly metabolize glucose to lactic acid - it is therefore essential to minimize glycolysis of the blood sample (see Specimen Collection Criteria).

Clinical Utility

This assay aids in the evaluation of metabolic acidosis, regional or diffuse tissue hypoperfusion, hypoxia, shock, congestive heart failure, dehydration, complicated postoperative state, ketoacidosis or nonketotic acidosis in diabetes mellitus, patients with infections, inflammatory states, certain myopathies, acute leukemia and other neoplasia, enzyme defects, glycogen storage disease (type1), thiamine deficiency and hepatic failure.

CPT Codes

83605
LOINC: 30241-4, 30242-2, 2524-7

Contacts

Last Updated

3/21/2023