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Use of Lactate ProTM2 for measurement of fetal scalp blood lactate during labor – proposing new cutoffs for normality, preacidemia and acidemia : a cross-sectional study

Iorizzo, L. LU ; Klausen, T. W.; Wiberg-Itzel, E.; Ovin, F. and Wiberg, N. LU (2018) In Journal of Maternal-Fetal and Neonatal Medicine p.1-7
Abstract

Objective: Measurement of fetal scalp blood lactate is a supplementary tool to cardiotocography in the case of a non-reassuring tracing. Several hand-held lactate meters have been launched, all with differentials in absolute values. Therefore, the reference intervals must be calculated for each device. The internationally accepted reference interval is based on measurement with Lactate ProTM with recently got out of production. The aim of this study was to propose cutoffs for normality, preacidemia, and acidemia in fetal scalp blood for Lactate ProTM2 based on the comparison of lactate values measured with Lactate ProTM and Lactate ProTM2. Design: Seven hundred one fetal scalp blood samples... (More)

Objective: Measurement of fetal scalp blood lactate is a supplementary tool to cardiotocography in the case of a non-reassuring tracing. Several hand-held lactate meters have been launched, all with differentials in absolute values. Therefore, the reference intervals must be calculated for each device. The internationally accepted reference interval is based on measurement with Lactate ProTM with recently got out of production. The aim of this study was to propose cutoffs for normality, preacidemia, and acidemia in fetal scalp blood for Lactate ProTM2 based on the comparison of lactate values measured with Lactate ProTM and Lactate ProTM2. Design: Seven hundred one fetal scalp blood samples were analyzed simultaneously. The conversion equations were retrieved from the linear regression model. On the basis of the cutoffs for Lactate ProTM cutoffs for Lactate ProTM2 were calculated. Results: The conversion equations obtained were Lactate ProTM = −0.02 + 0.68 × Lactate ProTM2 (SD: −0.09–0.07 × Lactate ProTM2) and Lactate proTM2 (LP2) = 0.03 + 1.48 × Lactate ProTM (SD: 0.16 + 0.17 × Lactate ProTM). The correlation to umbilical arterial pH was identical for the two devices (r = −0.18), whereas the correlation to umbilical arterial lactate was better for Lactate ProTM than for Lactate ProTM2 (r = 0.38, respectively, r = 0.33). The correlation to umbilical arterial lactate was dependent on time from sampling to delivery. Conclusion: Proposed reference values for Lactate ProTM2: scalp lactate <6.3 mmol/L = normal, no indication for intervention; 6.3–7.1 mmol/L = preacidemia, repeated testing has to be considered; > 7.1 mmol/L = acidemia, expedite delivery.

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author
organization
publishing date
type
Contribution to journal
publication status
in press
subject
keywords
Fetal blood, fetal surveillance, lactate, point-of-care device
in
Journal of Maternal-Fetal and Neonatal Medicine
pages
7 pages
publisher
Taylor & Francis
external identifiers
  • scopus:85041003379
ISSN
1476-7058
DOI
10.1080/14767058.2017.1416603
language
English
LU publication?
yes
id
f77d2a5c-6c7b-438f-9871-c9a7de5ac716
date added to LUP
2018-02-23 18:46:38
date last changed
2018-05-29 09:21:51
@article{f77d2a5c-6c7b-438f-9871-c9a7de5ac716,
  abstract     = {<p>Objective: Measurement of fetal scalp blood lactate is a supplementary tool to cardiotocography in the case of a non-reassuring tracing. Several hand-held lactate meters have been launched, all with differentials in absolute values. Therefore, the reference intervals must be calculated for each device. The internationally accepted reference interval is based on measurement with Lactate Pro<sup>TM</sup> with recently got out of production. The aim of this study was to propose cutoffs for normality, preacidemia, and acidemia in fetal scalp blood for Lactate Pro<sup>TM</sup>2 based on the comparison of lactate values measured with Lactate Pro<sup>TM</sup> and Lactate Pro<sup>TM</sup>2. Design: Seven hundred one fetal scalp blood samples were analyzed simultaneously. The conversion equations were retrieved from the linear regression model. On the basis of the cutoffs for Lactate Pro<sup>TM</sup> cutoffs for Lactate Pro<sup>TM</sup>2 were calculated. Results: The conversion equations obtained were Lactate Pro<sup>TM</sup> = −0.02 + 0.68 × Lactate Pro<sup>TM</sup>2 (SD: −0.09–0.07 × Lactate Pro<sup>TM</sup>2) and Lactate pro<sup>TM</sup>2 (LP2) = 0.03 + 1.48 × Lactate Pro<sup>TM</sup> (SD: 0.16 + 0.17 × Lactate Pro<sup>TM</sup>). The correlation to umbilical arterial pH was identical for the two devices (r = −0.18), whereas the correlation to umbilical arterial lactate was better for Lactate Pro<sup>TM</sup> than for Lactate Pro<sup>TM</sup>2 (r = 0.38, respectively, r = 0.33). The correlation to umbilical arterial lactate was dependent on time from sampling to delivery. Conclusion: Proposed reference values for Lactate Pro<sup>TM</sup>2: scalp lactate &lt;6.3 mmol/L = normal, no indication for intervention; 6.3–7.1 mmol/L = preacidemia, repeated testing has to be considered; &gt; 7.1 mmol/L = acidemia, expedite delivery.</p>},
  author       = {Iorizzo, L. and Klausen, T. W. and Wiberg-Itzel, E. and Ovin, F. and Wiberg, N.},
  issn         = {1476-7058},
  keyword      = {Fetal blood,fetal surveillance,lactate,point-of-care device},
  language     = {eng},
  month        = {01},
  pages        = {1--7},
  publisher    = {Taylor & Francis},
  series       = {Journal of Maternal-Fetal and Neonatal Medicine},
  title        = {Use of Lactate Pro<sup>TM</sup>2 for measurement of fetal scalp blood lactate during labor – proposing new cutoffs for normality, preacidemia and acidemia : a cross-sectional study},
  url          = {http://dx.doi.org/10.1080/14767058.2017.1416603},
  year         = {2018},
}