JOURNAL HOME CME HOME THIS MONTH PAST ISSUES ETOC COLLECTIONS AUTHORS REVIEWERS EDITORIAL BOARD FEEDBACK RSS HELP
		QUICK SEARCH:   [advanced] Author: Keyword(s): Year:  Vol:  Page:

This Article Full Text Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Services Email this article to a colleague Similar articles in this journal Similar articles in ISI Web of Science Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Citing Articles Citing Articles via HighWire Citing Articles via ISI Web of Science (2) Citing Articles via Google Scholar Google Scholar Articles by Jahr, J. S. Articles by Driessen, B. Search for Related Content PubMed PubMed Citation Articles by Jahr, J. S. Articles by Driessen, B.

---

TECHNOLOGY, COMPUTING, AND SIMULATION

Lactate Measurement Interference by Hemoglobin-Based Oxygen Carriers (Oxyglobin®, Hemopure®, and Hemolink^TM)

Departments of Anesthesiology and Pathology and Laboratory Medicine, David Geffen School of Medicine at UCLA, Los Angeles, California, and Department of Anesthesiology, Charles R. Drew University of Medicine and Science, Martin Luther King, Jr./Drew Medical Center, Los Angeles, California; Johns Hopkins University School of Medicine, Baltimore, Maryland; National Institute of Public Health, Cuernavaca, Mexico; Departments of Surgery and Medical Pathology, UC Davis School of Medicine; and Department of Clinical Studies, New Bolton Center, School of Veterinary Medicine, University of Pennsylvania, Philadelphia, Pennsylvania

Address correspondence and reprint requests to Jonathan S. Jahr, MD, Department of Anesthesiology, David Geffen School of Medicine at UCLA, PO Box 951778, Los Angeles, CA, 90095-1778. Address e-mail to jsjahr{at}mednet.ucla.edu.

We sought to determine whether hemoglobin-based oxygen carriers (HBOCs), hemoglobin glutamer-200 [bovine] (HBOC-200, Oxyglobin®), hemoglobin glutamer-250 [bovine] (HBOC-201, Hemopure®), and hemoglobin raffimer (Hemolink^TM) interfere with the accuracy of lactate measurements. Combinations of concentrated L-lactate solution, HBOC, and blood or plasma with added PlasmaLyte-A^TM were added to sample tubes to make a linear and constant increase in lactate concentration in consecutive samples. Sample lactate concentrations ranged from 5–110 mg/dL (0.6–12 mm) (physiological reference range: 5–20 mg/dL [0.56–2.2 mm]). Comparisons were made between machine measured lactate concentrations and calculated lactate concentrations. For Hb glutamer-250, the average difference between measured and calculated lactate concentrations was –5.1 mg/dL (–0.57 mm) (LX-20®), with greater underestimation at larger lactate concentrations. For Hb raffimer, the average difference was –2.2 mg/dL (–0.24 mm) (LX-20®). The veterinary product, Hb glutamer-200, was tested on 3 analyzers (LX-20®, YSI 1500, and YSI 2300). The YSI 1500 was the most accurate instrument with the mean difference between measured minus calculated lactate being +1.3 mg/dL versus –2.6 mg/dL (YSI 2300) and –8.4 mg/dL (LX-20®). The clinical implications of this study are that with increasing levels of an HBOC in plasma, lactate interpretation may become inaccurate, especially at larger lactate concentrations, causing underestimation of measured lactate values and possible under-treatment of the patient. Therefore, caution must be exercised when interpreting lactate results when a HBOC is present in plasma.

This article has been cited by other articles:

				C. Natanson, S. J. Kern, P. Lurie, S. M. Banks, and S. M. Wolfe Cell-Free Hemoglobin-Based Blood Substitutes and Risk of Myocardial Infarction and Death: A Meta-analysis JAMA, May 21, 2008; 299(19): 2304 - 2312. [Abstract] [Full Text] [PDF]

Anesthesia & Analgesia® is published for the International Anesthesia Research Society® by Lippincott Williams & Wilkins with the assistance of Stanford University Libraries' HighWire Press®. Copyright 2006 by the International Anesthesia Research Society. Online ISSN: 1526-7598   Print ISSN: 0003-2999