CG4 LActate Validation
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Hi Everyone,
Does anybody want to share how they did their lactate validation (CG4)? Did you have patients with lactates >10 mmol/L? I am currently doing method validation for CG4 cartridges to be used by NICU but I am pulling my hair trying to figure out how I am going to get real high results. What sample type did you use to compare? Thank you very much.
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We just let the heparin tubes sit out at room temperature. The longer the time the sample sits at room temperature, the higher the lactate level gets.
Did anyone have to do correlations with a gray top tube on an 1800. How did you accomplish that . Did you run gray top plasma on the I-STAT even though that is not the preferred specimen ? TIA
We did a correlation using a gray tube on our chemistry analyzer and a green with the i-STAT. We were able to get some samples elevated by having our volunteers
exercise prior to collection, i.e. run up and down 6 flights of stairs.
Hi Debra,
Did you use the same specimen from the grey tube to the iSTAT?
We use heparin (green top) tubes for lactate testing in our lab. During correlation time, I will run the lactate on the ISTAT then pull some off to spin and run on our lab analyzer. A few hours later, I will repeat. I can get 2-3 runs off one tube, all different values.
I also used heparinized samples for both analyzers. Lactate content really rises quickly in non-fluoride samples, so you really do need to work quickly. Fluoride is not specifically listed as an interferent for iSTAT (like it is for Radiometer), but heparin samples worked OK too - again as long as you work quickly to prepare your plasma after testing as whole blood.
Awesome! Thank you so much for sharing! :)
What samples did you guys used? I am new so I don't really know how important sample type would be. Our CG4 we will be using them for arterial, venous and capillary. So far, I got one arterial sample I did for validation but does it really matter to get all 3 sample types? Our reference range is the same for all the 3 sample types. Help! Thank you
Madonna,
I-Stat Arterial & Venous Reference Ranges are different for Lactate. You can print out and review the Abbott Procedure online.
You can also edit for your unique testing menu if you need a policy.
If you’re using Lactate for a Sepsis Protocol you would need to make sure they use the same sample type on the next draw.
We just report Venous Lactates in case the second sample is analyzed by our main lab.
Good luck!
Curious if anyone has venous and arterial lactates as separate tests in the EMR. So if a user draws a lactate from the art line, it would result as an arterial lactate vs. a venous lactate? If so, do they appear inthe lab section next to each other so the provider can easily compare the results for trends?
Hi Carolyn,
We have Arterial and Venous CG4 orders but the results are not next to each other though they are in the same lab section.
We do not list as separate tests, as there is negligible difference between the two sample types.
Thank you. I am torn between what to do. Our intensivist agrees with James,that the difference isnt clinically significant, but I feel it could be in certain situations. We may just add a comment to each result specifiying the source and keep it as one test.
It's probably one of those things that we 'laboratorians' worry far more about than the clinical staff do!
The main reason we do the separate is we have our tests set up as panels, the operator can't select their Istat tests individually. For the CG4 they can only get BG/La. Since we have different ranges for our venous vs arterial blood gases for the CG4 we have venous and arterial Lactate tests.
If you have test selection on your Istats and the ranges are the same or similar adding the sample type would be easier.