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Epic Code LAB2111117 Lactate / Pyruvate Ratio

Important Note

Lactic Acid:

Avoid trauma to surrounding muscles when collecting Lactic Acid specimens.Tourniquets may cause erroneously elevated Lactic Acid results.

Pyruvic Acid:

This test must be drawn at the Spectrum Health Butterworth or 35 Michigan St. draw site location. Specimen may also be drawn at United Hospital Laboratory. Collect specimen in pre-chilled Lavender (EDTA) top tubes. Mix well. Immediately transfer 2 mL into perchloric acid solution and mix. Let stand in the refrigerator for 5-10 minutes to ensure complete precipitation of protein. Centrifuge or filter and submit clear filtrate.

Test Name Alias

Lactic Acid Blood Level | Lactate Pyruvate Blood Level | Pyruvic Acid | 623

Interface Order Alias

11138

Icons & Photos

 

Special Handling

 

Read all instructions carefully!

Collection Instructions

LACTIC ACID

Specimen Collection: Blood

 

Container(s): Gray Top (Potassium Oxalate and Sodium Fluoride) 

Preferred Volume to Collect: 3.0 mL

Minimum Volume to Collect: 1.0 mL

Neonate Volume to Collect: 1.0 mL

Capillary collect ok? No

Microtainer acceptable?  No

 

Collection Instructions:

  • Do not use tourniquet - Avoid trauma to surrounding muscles when collecting Lactic Acid specimens. Tourniquet use may cause erroneously elevated Lactic Acid results.
  • Do not allow patient to flex or clench fist
  • Avoid hemolysis
  • After collection, gently invert tube 8-10 times.
  • Deliver on ice immediately to the lab within 15 minutes after collection!
  • Process within 15 minutes– See Processing Instructions below

 

PYRUVIC ACID

Specimen Collection: Blood

 

Container(s): Collection: Pre-Chilled Lavender (EDTA) Submit: Pre-Chilled and prepared tube containing perchloric acid (provided by Toxicology Department or Laboratory)

Preferred Volume to Collect: 3.0 mL

Minimum Volume to Collect: 2.2 mL

Neonate Volume to Collect: 2.2 mL

Capillary collect ok? No

Microtainer acceptable?  No

 

Collection Instructions:

  • Pyruvic Acid tubes may be obtained from the Toxicology Deparment at Spectrum Health Regional Laboratory. (Grand Rapids) 616.267.2780
  • Collect specimens in pre-chilled lavender top tubes.
  • After collection, gently invert tube 8-10 times.
  • Immediately after collection, transfer 2.0 mL into a tube containing 2.0 mL ice cold 7% perchloric acid solution and mix (provided by Toxicology Laboratory)
  • Label perchloric acid tube and lactic acid tube. Remainder of lavender tube may be discarded in sharps container.
  • Deliver on ice immediately to the lab within 15 minutes after collection
  • Specimen must be processed immediately - see processing instructions below!

 

Processing Instructions (Laboratory, Outpatient or Off-site collection)

 

LACTIC ACID


Processed Specimen: Plasma 

Centrifuge/Spin: Yes

Aliquot: Yes

Processing Instructions:

  • Centrifuge within 15 minutes after collection
  • Specimen must be on ice
  • Transfer plasma into storage tube and freeze specimen

Minimum plasma volume: 0.5 mL

Transport Temperature: Frozen

 

PYRUVIC ACID

 

Centrifuge/Spin: Yes

Aliquot: Yes

Processing Instructions:

  • Immediately after collection, transfer 2.0 mL into a tube containing 2.0 mL ice-cold 7%perchloric acid solution and mix (provided by Toxicology Laboratory) 
  • Let stand in refrigerator for 5 – 10 minutes to ensure complete precipitation of protein.
  • Centrifuge or filter and submit clear filtrate.

Transport Temperature: Refrigerated

 

Specimen Stability

Lactic Acid:

Ambient: not stable unless spun within 15 minutes. Deliver on ice or spun, separated and frozen

Refrigerate: 72 hours (spun & separated)

Frozen: 4 days

Laboratory Retention: 72 hours

 

Pyruvic Acid:

 

Test Frequency

Lactic Acid:

Available 24 hours, usual TAT 1 day.

 

Pyruvic Acid:

Available 2 times per week, usual TAT1-3 days.

Reference Range

Laboratory Critical Values Table

 

Lactic Acid:

0.0 - 2.0 mmol/L

 

Pyruvic Acid:

0.03 – 0.15 mmol/L

Performing Department

Multiple Departments: Chemistry or Toxicology

Performing Department Laboratory Location

Spectrum Health Regional Laboratory, Grand Rapids, MI

Methodology

Enzymatic – colorimetric

CPT

Lactic Acid: 83605

Pyruvic Acid: 84210

CDM Code

4058254, 4028862

Epic Test ID

1230100864

LOINC

 

Result Alias Result Description LOINC code
20222 Lactic Acid 2524-7
21159 Pyruvic Acid 14121-8
22157 Lactate/Pyruvate Ratio N/A

 

Beaker LOINC

LACTIC ACID: 2524-7
PYRUVIC ACID: 14121-8

Additional Information

For Spectrum Health Hospital Laboratory Use:

Pyruvate instructions:

1 (3 mL) lavender top tube – Chilled

1 Pipette

1 pre-chilled and prepared tube containing perchloric acid

 

1. Get a biohazard bag with ice, place lavender tube and perchloric acid tube in side pouch of bag

2. Draw 2.2 mL minimum of blood in chilled lavender top tube for the pyruvate acid

3. Invert the lavender tube several times

4. Pipette 2 mL of blood from the lavender top and add it to the chilled tube with perchloric acid.

5. Label the tube

6. Invert the tube with perchloric acid several times

7. Place the tube in the blue bullet, then on the ice (put some ice in the blue bullet if possible.)

8. Put in biohazard bag, wrap in bubble wrap and send it

Reviewed Date

3/5/2020

Beaker Names

Beaker Procedure Name: LACTATE / PYRUVATE RATIO
Beaker Display Name: Lactate / Pyruvate Ratio
BEAKER TEST NAME: LACTATE / PYRUVATE RATIO
BEAKER TEST REPORT NAME: Lactate / Pyruvate Ratio

Beaker Synonyms

No synonym on file

Beaker Collection and Specimen Handling

BEAKER COLLECTION: LOOK+LOOK

Beaker Location, Container and Temperature

BW CHEMISTRY:LAVENDER/GRAY(Preferred)-Refrigerated
BW CHEMISTRY: 3 MLLAVENDER TOPTUBE A (Acceptable)-On Ice
BW CHEMISTRY: 6 MLGRAY TOPTUBE A (Acceptable)
BW TOXICOLOGY:LAVENDER/GRAY(Preferred)-Refrigerated
BW TOXICOLOGY: 3 MLLAVENDER TOPTUBE A (Acceptable)-On Ice
BW TOXICOLOGY: 6 MLGRAY TOPTUBE A (Acceptable)