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Mayo Test 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, P

Specimen Type

Plasma NaFl-KOx

Specimen 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 days

Specimen Retention Time

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