title: Cerebrospinal fluid lactate: measurement of an adult reference interval.
abstract: BACKGROUND
  Differentiating bacterial meningitis from viral meningitis is a diagnostic challenge. Cerebrospinal fluid lactate has been proposed as a valuable test to differentiate disease states; however, its use in adults is limited by a lack of robust reference interval data.
  
  
  METHODS
  Cerebrospinal fluid samples with no cells or organisms detected, no culture growth after 48 h, and no increase in cerebrospinal fluid bilirubin were used to derive reference interval data for cerebrospinal fluid lactate in adults (n = 120).
  
  
  RESULTS
  A cerebrospinal fluid lactate reference interval of 1.0 (90% CI 0.9-1.1) - 2.2 mmol/L (90% CI 2.0-2.6) was defined.
  
  
  CONCLUSIONS
  Cerebrospinal fluid lactate results are rapidly available to the clinician. When interpreted against the adult reference interval derived in this study, results can help to triage patients presenting with symptoms of meningitis.
authors.affiliation: Department of Clinical Biochemistry, York Hospital, York, UK sally.slack@nhs.net.
authors.forename: Sally D
authors.initials: SD
authors.lastname: Slack
authors.affiliation: Department of Clinical Biochemistry, York Hospital, York, UK.
authors.forename: Paul
authors.initials: P
authors.lastname: Turley
authors.affiliation: Department of Health Sciences, Hull York Medical School, Heslington, UK.
authors.forename: Victoria
authors.initials: V
authors.lastname: Allgar
authors.affiliation: Department of Clinical Biochemistry, York Hospital, York, UK.
authors.forename: Ian B
authors.initials: IB
authors.lastname: Holbrook
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D019963:Clinical Chemistry Tests / Q000592:standards*; D003937:Diagnosis, Differential; D005260:Female; D006801:Humans; D019344:Lactic Acid / Q000134:cerebrospinal fluid*; D008297:Male; D016920:Meningitis, Bacterial / Q000134:cerebrospinal fluid / Q000175:diagnosis; D008587:Meningitis, Viral / Q000134:cerebrospinal fluid / Q000175:diagnosis; D008875:Middle Aged; D012016:Reference Values; D055815:Young Adult
chemical_list: D019344:Lactic Acid
keywords: Neurological disorders; clinical studies; statistics