Accuracy of a hand-held lactate meter in measuring umbilical cord blood lactate at all lactate levels

Abstract

Objective: Fetal scalp lactate has largely replaced pH analysis to assess intrapartum hypoxia. Many obstetrics units use hand-held lactate meters to measure umbilical blood because of its affordability and ease of use. We sought to investigate the agreement of Lactate Pro TM with a reference method blood gas analyser and to determine its usefulness with a recommended cutoff value of 4.8 mmol/L. Methods: Prospective study carried out at a tertiary institution where 237 arterial and 233 venous samples from umbilical cords of 16 elective caesarean and 285 emergency deliveries were measured using Lactate Pro TM and ABL735 Sesries Acid-Base analyser. Limits of agreement were analysed using Bland-Altman plots. Results: Lactate Pro TM differentiated fewer deliveries as "high risk" (≥4.8 mmol/L) and more as "low risk" (<2.2 mmol/L). Limits of agreement for lactate values (as measured by Lactate Pro TM) were-1.46-0.97 mmol/L for arterial lactate levels <4.8 mmol/L and-3.21-0.88 mmol/L for arterial lactate levels ≥ 4.8 mmol/L. Conclusion: There was a poorer agreement between the two devices at higher lactate values. Lactate Pro TM underestimates by up to 3.2 mmol/L; a 4.8 mmol/L reading may actually signify a lactate level of 8.0 mmol/L, indicating severe metabolic acidosis. We caution the use of this device in assessing fetal lactate levels.

Reliability of Lactate Scout Portable Analyzer in Agility Dogs During Multiple Measurements

“…in fi eld conditions. Moreover the portable analyzers could be more practical to use during some critical interventions [11,12]. The latest studies showed the introduction of the lactate pocket analyzer in ovine medicine [13].…”