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Test Code LACS1 Lactate, Plasma

Important Note

1. Lactic Acid is performed by Respiratory Therapy. They are ordered as a .POC Lactate, Venous

2. This test must be collected in OPL at the main hospital campus.

3. Phlebotomy staff will contact Respiratory Therapy staff for its collection.


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


Supplies: Sarstedt Aliquot Tube, 5 mL (T914)

Collection Container/Tube: Gray top (potassium oxalate/sodium fluoride)

Submission Container/Tube: Plastic vial

Specimen Volume: 0.625 mL Plasma

Collection Instructions:

1. Draw at least 1 mL whole blood in a 2-mL collection tube or at least 2 mL whole blood in a 4-mL collection tube.

2. Centrifuge and aliquot plasma into a plastic vial.


Useful For

Diagnosing and monitoring patients with lactic acidosis

 

Screening high-risk patients for sepsis or septic shock

Method Name

Enzymatic Colorimetric

Reporting Name

Lactate, P

Specimen Type

Plasma NaFl-KOx

Specimen Minimum Volume

Plasma: 0.25 mL

Specimen Stability Information

Specimen Type Temperature Time
Plasma NaFl-KOx Refrigerated (preferred) 14 days
  Ambient  8 hours

Reference Values

0-2 months: ≤3.3 mmol/L

3-24 months: ≤3.1 mmol/L

25 months-17 years: ≤2.2 mmol/L

> or  18 years: 0.5-2.0 mmol/L*

 

*Further information regarding the adult clinical action limit is available:

Townsend SR, Phillips GS, Duseja R, et al. Effects of compliance with the early management bundle (SEP-1) on mortality changes among medicare beneficiaries with sepsis: A propensity score matched cohort study. Chest. 2022;161(2):392-406. doi:10.1016/j.chest.2021.07.2167

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.

 

Elevated lactate (above laboratory reference interval or above 2.0 mmol/L in the absence of hypovolemia) in the context of sepsis evaluation in the hospital may warrant additional investigation to determine if sepsis or septic shock is present or developing.

 

Adult clinical action limit: Concentration greater than 2.0 mmol/L will flag as abnormal.(1)

Clinical Reference

1. Townsend SR, Phillips GS, Duseja R, et al. Effects of compliance with the early management bundle (SEP-1) on mortality changes among medicare beneficiaries with sepsis: A propensity score matched cohort study. Chest. 2022;161(2):392-406. doi:10.1016/j.chest.2021.07.2167

2. 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

3. Duke T: Dysoxia and lactate. Arch Dis Child. 1999;81(4):343-350. doi:10.1136/adc.81.4.343

4. 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

Day(s) Performed

Monday through Sunday

Report Available

Same day/1 to 2 days

Performing Laboratory

Mayo Clinic Laboratories in Rochester

Test 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

LOINC Code Information

Test ID Test Order Name Order LOINC Value
LACS1 Lactate, P 2524-7

 

Result ID Test Result Name Result LOINC Value
LACS1 Lactate, P 2524-7