Lactate point-of-care testing for acidosis: Cross-comparison of two devices with routine laboratory results

Abstract Objectives Lactate is a major parameter in medical decision making. During labor, it is an indicator for fetal acidosis and immediate intervention. In the Emergency Department (ED), rapid analysis of lactate/blood gas is crucial for optimal patient care. Our objectives were to cross-compare-for the first time-two point-of-care testing (POCT) lactate devices with routine laboratory results using novel tight precision targets and evaluate different lactate cut-off concentrations to predict metabolic acidosis. Design and methods Blood samples from the delivery room ( n =66) and from the ED ( n =85) were analyzed on two POCT devices, the StatStrip-Lactate (Nova Biomedical) and the iSTAT-1 (CG4+ cassettes, Abbott), and compared to the routine laboratory analyzer (ABL-735, Radiometer). Lactate concentrations were cross-compared between these analyzers. Results The StatStrip correlated well with the ABL-735 ( R =0.9737) and with the iSTAT-1 ( R =0.9774) for lactate in umbilical cord blood. Lactate concentrations in ED samples measured on the iSTAT-1 and ABL-735 showed a correlation coefficient of R =0.9953. Analytical imprecision was excellent for lactate and pH, while for pO 2 and pCO 2 the coefficient of variation was relatively high using the iSTAT-1. Conclusion Both POCT devices showed adequate analytical performance to measure lactate. The StatStrip can indicate metabolic acidosis in 1 μl blood and will be implemented at the delivery room.