title: Evaluation of 4 point-of-care units for the determination of blood l-lactate concentration in cattle.
abstract: BACKGROUND
  Despite being used commonly in bovine medicine, information on reliability of point-of-care (POC) lactate meters is limited.
  
  
  OBJECTIVE
  To determine the validity of 4 commercially available POC lactate meters in cattle.
  
  
  METHODS
  Cattle with various diseases (n = 120).
  
  
  METHODS
  Blood samples collected from the jugular vein were processed immediately on POC lactate meters. Plasma l-lactate concentration was measured by the enzymatic-colorimetric method (ELISA). Data were subjected to Friedman's test for comparison, Passing-Bablok regression and Bland-Altman plot analyses for reliability, and receiver operating characteristics analysis for sensitivity (Se) and specificity (Sp).
  
  
  RESULTS
  The POC lactate meters were highly correlated with ELISA (r = 0.98-0.99) despite disagreements among units. When regressed on ELISA, blood l-lactate concentrations generated from Accutrend Plus and Lactate Pro were linear up to 16.6 and 15.7 mmol/L, respectively, whereas those generated from i-STAT and Lactate Scout were linear up to 19.5 and 19.7 mmol/L, respectively. All POC lactate meters had a Se of 100% with Sp of 95.7-98.6% at a plasma l-lactate cut-off concentration of 4 mmol/L. i-STAT had the best accuracy (99.0%) and precision (99.8%), the best linear fit (y = -0.13 + 1.04X) yielding the lowest bias (-6.6%) as well as the highest Se (100%) and Sp (98.6%).
  
  
  CONCLUSIONS
  Despite high correlation with the reference method, dilution is needed for Accutrend Plus/Lactate Pro and i-STAT/Lactate Scout if concentrations >15 and 20 mmol/L, respectively. i-STAT provided the most accurate and precise results.
authors.affiliation: Faculty of Veterinary Medicine, Department of Internal Medicine, Firat University, Elazig, Turkey.
authors.forename: T
authors.initials: T
authors.lastname: Karapinar
authors.forename: O
authors.initials: O
authors.lastname: Kaynar
authors.forename: A
authors.initials: A
authors.lastname: Hayirli
authors.forename: M
authors.initials: M
authors.lastname: Kom
mesh_terms: D000818:Animals; D002417:Cattle; D002418:Cattle Diseases / Q000097:blood*; D004797:Enzyme-Linked Immunosorbent Assay / Q000662:veterinary; D019344:Lactic Acid / Q000097:blood*; D019095:Point-of-Care Systems / Q000592:standards*; D012372:ROC Curve; D012044:Regression Analysis; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity
chemical_list: D019344:Lactic Acid
keywords: Accuracy; Bovine; Portable lactate meter; Precision; Sensitivity; Specificity