title: Assessment of a point-of-care lactate monitor in emergency admissions of adult horses to a referral hospital.
abstract: BACKGROUND
  Blood lactate concentration [LAC] is considered a useful indicator of disease severity in horses. Agreement of point-of-care (POC) lactate monitors with laboratory standards has not been established for clinically abnormal horses.
  
  
  OBJECTIVE
  It was hypothesized that results from a POC lactate monitor would be in agreement with a laboratory-based measurement of [LAC].
  
  
  METHODS
  The study included adult horses presented for emergency evaluation.
  
  
  METHODS
  A prospective observational study was performed. [LAC] was measured with whole blood (AWB) and plasma (APL) by means of a POC monitor (Accutrend) and compared with results from whole blood measured by a laboratory blood gas analyzer (NOVA).
  
  
  RESULTS
  Samples from 221 horses were used to compare the 2 lactate measurement techniques. Agreement (p +/- SE) was closest between APL and NOVA (0.97 +/- 0.01); an average observed difference of 0.15 +/- 0.89 (mean +/- SD) and 95% limits of agreement (LOA) -1.89, 1.59 also were found. Agreement was preserved and 95% LOA further decreased in horses with NOVA [LAC] of <5 mM and PCV <40%. Agreement was modest when testing whole blood samples on the POC monitor with increased 95% LOA.
  
  
  CONCLUSIONS
  Results indicate close agreement between NOVA and the POC monitor when [LAC] was measured with plasma. Results were less consistent at higher [LAC] but sufficiently reliable to follow trends. Although whole blood may be used with the POC monitor to identify clinically important hyperlactatemia, results may be insufficiently reliable to monitor trends.
authors.affiliation: Department of Medicine, University of Pennsylvania Department of Clinical Studies-New Bolton Center, School of Veterinary Medicine, 382 West Street Road, Kennett Square, PA 19348, USA.
authors.forename: Brett S
authors.initials: BS
authors.lastname: Tennent-Brown
authors.forename: Pamela A
authors.initials: PA
authors.lastname: Wilkins
authors.forename: Sue
authors.initials: S
authors.lastname: Lindborg
authors.forename: Gail
authors.initials: G
authors.lastname: Russell
authors.forename: Raymond C
authors.initials: RC
authors.lastname: Boston
mesh_terms: D000818:Animals; D001784:Blood Gas Analysis / Q000662:veterinary; D004632:Emergency Medical Services / Q000379:methods*; D005260:Female; D006400:Hematocrit / Q000662:veterinary; D006734:Horse Diseases / Q000097:blood*; D006736:Horses; D019344:Lactic Acid / Q000097:blood*; D008297:Male; D010865:Pilot Projects; D019095:Point-of-Care Systems; D011446:Prospective Studies; D012044:Regression Analysis
chemical_list: D019344:Lactic Acid