Open AccessAssessment of a Point‐of‐Care Lactate Monitor in Emergency Admissions of Adult Horses to a Referral Hospital
Author(s) -
TennentBrown Brett S.,
Wilkins Pamela A.,
Lindborg Sue,
Russell Gail,
Boston Raymond C.
Publication year - 2007
Publication title -
journal of veterinary internal medicine
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.356
H-Index - 103
eISSN - 1939-1676
pISSN - 0891-6640
DOI - 10.1111/j.1939-1676.2007.tb03069.x
Subject(s) - medicine , hyperlactatemia , limits of agreement , blood lactate , whole blood , point of care , horse , emergency medicine , referral , blood collection , nuclear medicine , pathology , paleontology , heart rate , family medicine , blood pressure , biology
Background : Blood lactate concentration [LAC] is considered a useful indicator of disease severity in horses. Agreement of point‐of‐care (POC) lactate monitors with laboratory standards has not been established for clinically abnormal horses. Hypothesis : It was hypothesized that results from a POC lactate monitor would be in agreement with a laboratory‐based measurement of [LAC]. Animals : The study included adult horses presented for emergency evaluation. Methods : A prospective observational study was performed. [LAC] was measured with whole blood (AWB) and plasma (APL) by means of a POC monitor (Accutrend) and compared with results from whole blood measured by a laboratory blood gas analyzer (NOVA). Results : Samples from 221 horses were used to compare the 2 lactate measurement techniques. Agreement (p ± SE) was closest between APL and NOVA (0.97 ± 0.01); an average observed difference of 0.15 ± 0.89 (mean ± SD) and 95% limits of agreement (LOA) ‐1.89, 1.59 also were found. Agreement was preserved and 95% LOA further decreased in horses with NOVA [LAC] of <5 mM and PCV <40%. Agreement was modest when testing whole blood samples on the POC monitor with increased 95% LOA. Conclusions and Clinical Importance : Results indicate close agreement between NOVA and the POC monitor when [LAC] was measured with plasma. Results were less consistent at higher [LAC] but sufficiently reliable to follow trends. Although whole blood may be used with the POC monitor to identify clinically important hyperlactatemia, results may be insufficiently reliable to monitor trends.