Lactate study using umbilical cord blood: Agreement between Lactate Pro hand-held devices with blood gas analyser and evaluation of lactate stability over time

Su, Tina Y.; Reece, Mifanwy; Chua, Seng Chai

doi:10.1111/ajo.12081

Cited by 4 publications

(4 citation statements)

References 26 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…The limits of agreement were validated in a study by Tanner et al 2010 where they were ±2.1 mmol/L [33]. Our previous study showed there were good levels of agreement at low lactate levels in elective Caesarean sections [10]. The between-run coefficient of variation was 3% -5% [8,35] and may be as high as 8.4% in our study, which related to neonates at risk of birth hypoxia.…”

Section: Discussionsupporting

confidence: 77%

“…However their study did not include samples with lactate concentration high enough to detect the proportional negative bias. In the first part of the study, we found insignificant differences between Lactate Pro and blood gas analyser at low lactate values [10]. Although the manufacturer's specifications indicate Lactate Pro measures lactate concentrations in whole blood between 0.8 and 23 mmol/L, few studies have explored its accuracy at such high lactate levels.…”

Section: Discussionmentioning

confidence: 82%

“…Arterial samples were drawn from the umbilical artery followed by venous samples drawn from the umbilical vein using 23 gauge needles into pre-labelled 1 cm 3 pre-heparinised syringes and kept on ice. We have previously established that lactate remains stable over ice [10].…”

Section: Methodsmentioning

confidence: 99%

See 2 more Smart Citations

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

Chua¹,

Wong²,

Su³

et al. 2014

OJOG

Self Cite

View full text Add to dashboard Cite

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.

show abstract

Section: Discussionsupporting

confidence: 77%

Section: Discussionmentioning

confidence: 82%

See 1 more Smart Citation

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

Chua¹,

Wong²,

Su³

et al. 2014

OJOG

Self Cite

View full text Add to dashboard Cite

show abstract

“…Alternatively, lactate has repeatedly been shown to correlate with umbilical cord pH and to have reasonable accuracy in predicting poor neonatal outcome. [28][29][30][31][32][33][34][35][36][37][38][39] Moreover, it can be measured using a hand-held meter with as little as 5 ll of blood. 30,40 This review aims to synthesise evidence on the diagnostic test accuracy of umbilical cord lactate in measuring acidosis and predicting poor neonatal outcome by comparing umbilical cord lactate with other assessments of acidosis in the immediate newborn and by assessing the ability of umbilical cord lactate to predict neonatal outcomes.…”

Section: Introductionmentioning

confidence: 99%

Umbilical lactate as a measure of acidosis and predictor of neonatal risk: a systematic review

Allanson

Waqar

White

et al. 2016

BJOG

View full text Add to dashboard Cite

Background Umbilical cord lactate is one approach to measuring acidosis and intrapartum hypoxia, knowledge of which may be helpful for clinicians involved in the care of women and newborns.Objective To synthesise the evidence on accuracy of umbilical cord lactate in measuring acidosis and predicting poor neonatal outcome.Search strategy Studies published and unpublished between 1990 and 2014 from PubMed/Medline, EMBASE, Cochrane Central Register of Controlled Trials, and clinicaltrials.gov were assessed.Selection criteria Cross-sectional and randomised studies that assessed fetal acidosis (using lactate as the index test) with or without an assessment of neonatal outcome.Data collection and analysis Correlations between index and reference test(s) were recorded, as were the raw data to classify the predictive ability of umbilical lactate for neonatal outcomes. Metaanalysis of correlation was performed. We plotted estimates of the studies' observed sensitivities and specificities on Forest plots with 95% confidence intervals (CI). Where possible, we combined data using meta-analysis, applying the hierarchical summary receiver operating characteristics model and a bivariate model.Main results Twelve studies were included. Umbilical lactate correlated with pH [pooled effect size (ES) À0.650; 95% CI À0.663 to À0.637, P < 0.001], base excess (ES À0.710; 95% CI À0.721 to À0.699, P < 0.001), and Apgar scores at 5 minutes (ES 0.300; 95% 0.193-0.407, P < 0.001). Umbilical lactate had pooled sensitivity and specificity for predicting neonatal neurological outcome including hypoxic ischaemic encephalopathy of 69.7% (95% CI 23.8-94.4%) and 93% (95% CI 86.8-96.3%).Authors' conclusion Umbilical cord lactate is a clinically applicable, inexpensive and effective way to measure acidosis and is a tool that may be used in the assessment of neonatal outcome.

show abstract

Intrapartum fetal scalp lactate sampling for fetal assessment in the presence of a non-reassuring fetal heart rate trace

East

Leader

Sheehan

et al. 2015

Cochrane Database of Systematic Reviews

View full text Add to dashboard Cite

show abstract

Lactate study using umbilical cord blood: Agreement between Lactate Pro hand-held devices with blood gas analyser and evaluation of lactate stability over time

Cited by 4 publications

References 26 publications

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

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

Umbilical lactate as a measure of acidosis and predictor of neonatal risk: a systematic review

Intrapartum fetal scalp lactate sampling for fetal assessment in the presence of a non-reassuring fetal heart rate trace

Contact Info

Product

Resources

About