Fetal scalp and umbilical artery blood lactate measured with a new test strip method

Nordström, Lennart; Persson, Bengt; Shimojo, Nobuo; Westgren, Magnus

doi:10.1111/j.1471-0528.1992.tb13728.x

Cited by 20 publications

(15 citation statements)

References 8 publications

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“…It is a known fact that reflectometric methods, where plasma diffusion through a filter is included in the analyzing technique, can give false low readings due to slower dif-fusion of the plasma in samples with high Hkt [5,8]. With the electrochemical device lower measurements with high Hkt has been reported previously, especially for specimen with high lactate concentrations [9].…”

Section: Discussionmentioning

confidence: 99%

“…However, earlier lactate determinations have only been carried out in research projects as sampling volumes needed were large, a minimum of 150 , thereby making it not practical in the analysis in fetal scalp blood samples (FBS) in the clinical management of intrapartum fetal distress. With the launch of new microvolume test strip methods (5)(6)(7)(8)(9)(10)(11)(12)(13)(14)(15)(16)(17)(18)(19)(20) renewed interest for lactate determinations in obstetric practice has emerged [5,7]. Today at least two test strip lactate meters are available on the market, the Accusport™ (Boeringer Mannheim, East Sussex, UK) and the Lactate Pro™ (KDK Corporation, Kyoto, Japan) (figure 1).…”

Section: Introductionmentioning

confidence: 99%

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Quality assessment of two lactate test strip methods suitable for obstetric use

Nordström¹,

Chua²,

Roy³

et al. 1998

Jpme

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Accuracy of lactate determinations in cord blood was tested for one reflectometric (Accusport) and one amperometric (Lactate Pro) microvolume test strip lactate meter. Both meters, using a whole blood sample, measure lower levels of lactate than a reflectometric device considered as a reference method, which analyses lactate in plasma. Readings were unaffected irrespective of lactate concentrations for the Lactate Pro, whilst the Accusport overestimated low lactate concentrations and underestimated high values. Both lactate meters underestimated lactate concentrations at high hematocrits, as compared with the reference method. The Lactate Pro has a fixed sample volume of 5 microliters while the Accusport uses random blood drop as sample volume. However, in analyses with less than 20 microliters sample volume considerable underestimation was found with the Accusport. Coefficient of variation was 3.8-8.9% for the Accusport and 3.1-4.0% for the Lactate Pro within lactate concentrations between 2.1 and 5.3 mmol/l. The amperometric device, the Lactate Pro, performed best in these tests dealing with fetal blood lactate concentrations. The new technique can be a useful tool in perinatal research as well as in obstetric practice.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Quality assessment of two lactate test strip methods suitable for obstetric use

Nordström¹,

Chua²,

Roy³

et al. 1998

Jpme

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“…The test range is 0.7-26 mmol/1 for plasma samples. The method has been reported to be accurate and reliable [13]. The enzymat ic reaction requires lactate oxidase and fcrrocyanide as an electron mediator.…”

Section: Blood Glucose and Lactate Measurementmentioning

confidence: 99%

Effects of Hyperglycemia on Gasping and Autoresuscitation in Newborn Rats

Yuan¹,

Blennow²,

Runold³

et al. 1997

Neonatology

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The aim of this study was to test the effects of glucose on the gasping ability and survival in a rat pup model during acute anoxia. Newborn rat pups of both 1 and 8 days of age were given glucose (30 and 60 mg/animal) or saline intraperitoneally and subsequently subjected to anoxia (100% N₂). Glucose supplement induced hyperglycemia. Respiration was recorded by barometric plethysmography. The rat pups responded to acute anoxia with a robust sequence of respiratory pattern: hyperpnea, primary apnea, hypoxic gasping and secondary apnea. During anoxia the 1-day-old rats gasped much longer than the 8-day-old rats (23.4 ± 1.0 vs. 6.1 ± 0.5 min, p < 0.001). No difference was found in gasping duration between the saline control and the glucose-supplemented 1-day-old rat pups. The 8-day-old supplemented rats gasped much longer (9.3 ± 0.5 min) than the control rats (6.1 ± 0.5 min, p < 0.01). The animals autoresuscitated when they received oxygen (100%) during the gasping period. When oxygen was given after the gasping period, the survival rate was 33.3% in control and 0% in supplemented 1-day-old rats, and 100% in control and 50% in glucose-supplemented 8-day-old rats (p < 0.02). Further controlled experiments for a fixed period of anoxia to 13.5 min resulted in survival rates of 50.0% for controls and 28.6% for supplemented animals, respectively. The overall survival rate was then 85.2% in control and 52.9% in supplemented 8-day-old rats (p < 0.05). Lactate concentration in blood rapidly increased in the first 6 min of anoxia and thereafter gradually increased to 22.1 mmol/l around the last gasp in the 1-day-old rats. Hyperglycemia did not cause further accumulation of lactate despite a transient elevation over the control rats at 6 min of anoxia. In the 8-day-old supplemented animals the lactate level was only modestly increased, probably due to the prolonged gasping period. In conclusion, we found that gasping performance was well preserved in the 8-day-old glucose-supplemented rats, whereas the autoresuscitation mechanism after the last gasp might be altered due to hyperglycemia. In addition, the accumulation of lactate in the blood did not affect the gasping performance and the mechanisms of autoresuscitation.

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“…However, there is dissatisfaction with the use of umbilical cord acid base measurements as it may not be a good predictor of hypoxic encephalopathy or long-term sequelae associated with birth asphyxia. Animal studies have demonstrated the potential value of lactate measurements and studies are in progress to clarify its clinical usefulness as part of a 'biochemical Apgar score' [22,24]. Our study shows that Accusport is a convenient, easy to use system which provides accurate assessment of cord arterial lactate levels in the newborn and can possibly be used reliably to measure lactate from fetal scalp blood.…”

Section: Discussionmentioning

confidence: 93%

“…Recent studies have shown that fetal scalp blood lactate may also be used to accurately predict a depressed fetus [11,22]. Scalp pH reflects a transient respiratory acidosis which may be due to transient hypercapnia, a common event during normal labour [23].…”

Section: Discussionmentioning

confidence: 99%

Evaluation of a New Portable System for Cord Lactate Determination

Yam

Chua

Razvi

et al. 1998

Gynecol Obstet Invest

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To evaluate a new reflectance photometer (Accusport^®) for blood lactate determination, a prospective non-interventional study was performed on blood obtained from the umbilical cord artery immediately after delivery of the baby in 109 consecutive women. For each sample, the results of cord arterial blood lactate values measured with the reflectance photometer were compared with those obtained using a reference method in the laboratory. The values obtained using Accusport were comparable in accuracy with those obtained using a laboratory reference method (Ektachem 9501RC). The instrument provides a simple and reliable method for determining cord arterial blood lactate levels in a small blood sample.

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Fetal scalp and umbilical artery blood lactate measured with a new test strip method

Cited by 20 publications

References 8 publications

Quality assessment of two lactate test strip methods suitable for obstetric use

Quality assessment of two lactate test strip methods suitable for obstetric use

Effects of Hyperglycemia on Gasping and Autoresuscitation in Newborn Rats

Evaluation of a New Portable System for Cord Lactate Determination

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