Determination of the Effect of In Vitro Time, Temperature, and Tourniquet Use on Whole Blood Venous Point-of-care Lactate Concentrations

Alan E. Jones, Matthew M. Leonard, Jackeline Hernandez-Nino, Jeffrey Kline

Research output: Contribution to journalArticle

26 Citations (Scopus)

Abstract

Objectives: The authors sought to determine the effect of in vitro time, temperature, and removable tourniquet use on changes in venous point-of-care lactate concentrations. Methods: This was a prospective randomized trial on healthy volunteers. Subjects were randomized to one of three groups: group 1 had venous lactate concentrations measured on blood drawn without a tourniquet and the sample placed in ice (-1°C), group 2 had lactate concentrations measured on blood drawn without a tourniquet and the sample left at 23°C, and group 3 had lactate concentrations measured on blood drawn with a tourniquet placed 5 minutes before venipuncture and the sample placed in ice (-1°C). Lactate concentrations were measured on a point-of-care device at time 0, 3, 6, 9, 12, and 15 minutes in all three groups. Mean lactate concentrations were analyzed using a two-way repeated-measures analysis of variance. Results: Eighty subjects were randomized, with complete data available in 63 (21 per group). Over the 15-minute period, lactate concentrations increased 10% (0.14 ± 0.12 mmol/L) in group 1, 25% (0.33 ± 0.003 mmol/L) in group 2, and 6% (0.08 ± 0.22 mmol/L) in group 3. No significant differences in mean lactate concentrations were found between any group or time point by analysis of variance (p > 0.90). A 50% relative increase in lactate concentrations between time 0 and 15 minutes occurred in zero of 21 subjects in group 1, four of 21 in group 2, and one of 21 in group 3 (p = 0.05 group 1 vs. group 2, Fisher's exact test). Conclusions: Whole blood point-of-care lactate concentrations in healthy subjects do not change significantly over 15 minutes at either -1°C or 23°C, and the use of a tourniquet has no appreciable effect on lactate concentrations.

Original languageEnglish (US)
Pages (from-to)587-591
Number of pages5
JournalAcademic Emergency Medicine
Volume14
Issue number7
DOIs
StatePublished - Jul 2007
Externally publishedYes

Fingerprint

Point-of-Care Systems
Tourniquets
Lactic Acid
Temperature
Ice
Analysis of Variance
Healthy Volunteers
In Vitro Techniques
Phlebotomy

Keywords

  • lactate
  • lactic acidosis
  • whole blood measurement

ASJC Scopus subject areas

  • Emergency Medicine

Cite this

Determination of the Effect of In Vitro Time, Temperature, and Tourniquet Use on Whole Blood Venous Point-of-care Lactate Concentrations. / Jones, Alan E.; Leonard, Matthew M.; Hernandez-Nino, Jackeline; Kline, Jeffrey.

In: Academic Emergency Medicine, Vol. 14, No. 7, 07.2007, p. 587-591.

Research output: Contribution to journalArticle

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title = "Determination of the Effect of In Vitro Time, Temperature, and Tourniquet Use on Whole Blood Venous Point-of-care Lactate Concentrations",
abstract = "Objectives: The authors sought to determine the effect of in vitro time, temperature, and removable tourniquet use on changes in venous point-of-care lactate concentrations. Methods: This was a prospective randomized trial on healthy volunteers. Subjects were randomized to one of three groups: group 1 had venous lactate concentrations measured on blood drawn without a tourniquet and the sample placed in ice (-1°C), group 2 had lactate concentrations measured on blood drawn without a tourniquet and the sample left at 23°C, and group 3 had lactate concentrations measured on blood drawn with a tourniquet placed 5 minutes before venipuncture and the sample placed in ice (-1°C). Lactate concentrations were measured on a point-of-care device at time 0, 3, 6, 9, 12, and 15 minutes in all three groups. Mean lactate concentrations were analyzed using a two-way repeated-measures analysis of variance. Results: Eighty subjects were randomized, with complete data available in 63 (21 per group). Over the 15-minute period, lactate concentrations increased 10{\%} (0.14 ± 0.12 mmol/L) in group 1, 25{\%} (0.33 ± 0.003 mmol/L) in group 2, and 6{\%} (0.08 ± 0.22 mmol/L) in group 3. No significant differences in mean lactate concentrations were found between any group or time point by analysis of variance (p > 0.90). A 50{\%} relative increase in lactate concentrations between time 0 and 15 minutes occurred in zero of 21 subjects in group 1, four of 21 in group 2, and one of 21 in group 3 (p = 0.05 group 1 vs. group 2, Fisher's exact test). Conclusions: Whole blood point-of-care lactate concentrations in healthy subjects do not change significantly over 15 minutes at either -1°C or 23°C, and the use of a tourniquet has no appreciable effect on lactate concentrations.",
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AB - Objectives: The authors sought to determine the effect of in vitro time, temperature, and removable tourniquet use on changes in venous point-of-care lactate concentrations. Methods: This was a prospective randomized trial on healthy volunteers. Subjects were randomized to one of three groups: group 1 had venous lactate concentrations measured on blood drawn without a tourniquet and the sample placed in ice (-1°C), group 2 had lactate concentrations measured on blood drawn without a tourniquet and the sample left at 23°C, and group 3 had lactate concentrations measured on blood drawn with a tourniquet placed 5 minutes before venipuncture and the sample placed in ice (-1°C). Lactate concentrations were measured on a point-of-care device at time 0, 3, 6, 9, 12, and 15 minutes in all three groups. Mean lactate concentrations were analyzed using a two-way repeated-measures analysis of variance. Results: Eighty subjects were randomized, with complete data available in 63 (21 per group). Over the 15-minute period, lactate concentrations increased 10% (0.14 ± 0.12 mmol/L) in group 1, 25% (0.33 ± 0.003 mmol/L) in group 2, and 6% (0.08 ± 0.22 mmol/L) in group 3. No significant differences in mean lactate concentrations were found between any group or time point by analysis of variance (p > 0.90). A 50% relative increase in lactate concentrations between time 0 and 15 minutes occurred in zero of 21 subjects in group 1, four of 21 in group 2, and one of 21 in group 3 (p = 0.05 group 1 vs. group 2, Fisher's exact test). Conclusions: Whole blood point-of-care lactate concentrations in healthy subjects do not change significantly over 15 minutes at either -1°C or 23°C, and the use of a tourniquet has no appreciable effect on lactate concentrations.

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