The Science Journal of the American Association for Respiratory Care

2001 OPEN FORUM Abstracts

Comparison of Pointof Care Lactate Analysis to Laboratory Analysis in Pediatric Patients With CongenitalHeart Disease

Jenni L. Raake, BS, RRT, Jerri McNamara, BA, BS, CCP, Donna Kinnemeyer, MLT, Steven Schwartz, MD, David Nelson, MD, PhD The HEART Center, Children?s Hospital Medical Center, Cincinnati, OH

Intro: Lactic acid production from anaerobic metabolism can occur in hypoxia, cardiogenic and septic shock, heart failure, hypoxia, respiratory insufficiency and hematologic disorders. Serum lactate analysis is usually performed in the central laboratory, taking 45 ? 60 minutes. We evaluated the iSTAT CG4+ Lactate and Blood Gas Cartridge (I-STAT Corporation, East Windsor, NJ) in order to determine the correlation with centralized laboratory testing.

Methods: Split sample testing was performed on 45 samples from 5 patients with congenital heart defects. The blood was analyzed using the iSTAT CG4+ cartridge and analyzer, and the matched sample was shipped to the central laboratory on ice for analysis on the Vitros 950 Chemistry Analyzer (Ortho-Clinical Diagnostics, Raritan, NJ). Linear regression was used to determine correlation, slope, and intercept values. Bias and precision were determined using the technique described by Bland and Altman.

Results: Correlation coefficient (r value) was 0.99, slope was 0.986, intercept was ?0.1, (p<0.001). Bias was 0.1 mmol/L, while precision was 0.22. Results from the iSTAT CG4+ cartridge were available in two minutes. A cost comparison that included staff time revealed that laboratory costs were $7.50 while bedside testing costs were $5.79.

Conclusions: We found bedside lactate measurements using the iSTAT CG4+ cartridge to be rapid and cost effective, with good correlation to laboratory analysis.

OF-01-027

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