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HelpTest ID LACS1 Lactate, Plasma
Ordering Guidance
This test does not measure D-lactate, an uncommon, often undiagnosed cause of lactic acidosis. If D-lactate testing is needed, order DLAC / D-Lactate, Plasma.
Necessary Information
Patient's age and sex are required.
Specimen Required
Collection Container/Tube: Gray top (potassium oxalate/sodium fluoride)
Submission Container/Tube: Plastic vial
Specimen Volume: 0.5 mL
Collection Instructions:
1. Collection must be at least 1 mL in a 2-mL collection tube or at least 2 mL in a 4-mL collection tube.
2. Centrifuge and aliquot plasma into plastic vial.
Useful For
Diagnosing and monitoring patients with lactic acidosis
Method Name
Colorimetric
Reporting Name
Lactate, PSpecimen Type
Plasma NaFl-KOxSpecimen Minimum Volume
0.25 mL
Specimen Stability Information
| Specimen Type | Temperature | Time | Special Container |
|---|---|---|---|
| Plasma NaFl-KOx | Refrigerated (preferred) | 14 days | |
| Ambient | 8 hours |
Reject Due To
| Gross hemolysis | Reject |
Clinical Information
Anaerobic glycolysis markedly increases blood lactate and causes some increase in pyruvate levels, especially with prolonged exercise. The common cause for increased blood lactate and pyruvate is anoxia resulting from such conditions as shock, pneumonia, and congestive heart failure. Lactic acidosis may also occur in kidney failure and leukemia. Thiamine deficiency and diabetic ketoacidosis are associated with increased levels of lactate and pyruvate.
Lactate measurements that evaluate the acid-base status are used in the diagnosis and treatment of lactic acidosis (abnormally high acidity in the blood).
Reference Values
0-90 days (<3 months): 0.0-3.3 mmol/L
3-24 months: 0.0-3.1 mmol/L
>24 months-18 years: 0.0-2.2 mmol/L
>18 years: 0.5-2.2 mmol/L
Interpretation
While no definitive concentration of lactate has been established for the diagnosis of lactic acidosis, lactate concentrations exceeding 5 mmol/L and pH below 7.25 are generally considered indicative of significant lactic acidosis.
Cautions
Proper specimen collection and processing techniques are critical for reliable results.
Clinical Reference
1. Mizock BA. The hepatosplanchnic area and hyperlactatemia: A tale of two lactates. Crit Care Med. 2001;29(2):447-449. doi:10.1097/00003246-200102000-00047
2. Duke T: Dysoxia and lactate. Arch Dis Child. Oct;81(4):343-350. doi:10.1136/adc.81.4.343
3. Sacks D: Carbohydrates. In: Rifai N, Horvath AR, Wittwer CT, eds. Tietz Textbook of Clinical Chemistry and Molecular Diagnostics 6th ed. Elsevier; 2018:518-538
Method Description
Lactate concentration is determined using an enzymatic colorimetric method. L-lactate is oxidized to pyruvate by the specific enzyme lactate oxidase. Peroxidase is used to generate a colored dye using the hydrogen peroxide generated in the first reaction. The intensity of the color formed is directly proportional to the L-lactate concentration. It is determined by measuring the increase in absorbance.(Package insert: Roche Diagnostics, Indianapolis IN, 02/2016)
Day(s) Performed
Monday through Sunday
Report Available
Same day/1 to 2 daysTest Classification
This test has been cleared, approved, or is exempt by the US Food and Drug Administration and is used per manufacturer's instructions. Performance characteristics were verified by Mayo Clinic in a manner consistent with CLIA requirements.CPT Code Information
83605