title: The Effect of Inadequate Presample Blood Volume Withdrawal from Intravenous Catheter and Extension Sets on Measured Circulating L-Blood Lactate Concentration in Horses Receiving Lactated Ringer's Solution.
abstract: BACKGROUND
  Circulating l-lactate concentration is commonly measured in hospitalized horses by sampling from indwelling intravenous (IV) catheters. However, there are no published evidence-based recommendations to prevent contamination by lactated Ringer's solution (LRS).
  
  
  OBJECTIVE
  Withdrawing 10 mL of blood from the LRS-containing extension set connected to the IV catheter before obtaining the sample for analysis should be adequate to obtain accurate measurement of blood lactate concentration (BLC).
  
  
  METHODS
  Thirty-three adult hospitalized horses receiving constant rate infusion of LRS.
  
  
  METHODS
  Immediately after disconnecting the LRS, 5 sequential 5 mL blood samples were obtained by aspiration from an extension set connected to an indwelling IV catheter, followed by 3 samples collected by direct venipuncture of the contralateral jugular vein. Samples were analyzed with 1 portable blood lactate analyzer. A linear mixed model was used to examine differences in lactate concentrations among samples collected from the catheter and by direct venipuncture.
  
  
  RESULTS
  After considering differences in age, breed, sex, and reason for hospitalization, BLCs were higher (P < .001) in the first and second 5 mL samples collected through the extension set/catheter than in all other extension set/catheter samples or the direct venipuncture samples. The largest difference observed between the third and subsequent catheter or venipuncture samples was 0.34 mmol/L with an upper 95% CI of 1.12 mmol/L.
  
  
  CONCLUSIONS
  Withdrawing 15 mL of blood from a LRS-containing extension set connected to an IV catheter (5.9 mL total volume capacity) before obtaining the sample for blood lactate analysis is suggested to optimize accuracy of BLC measurements.
authors.affiliation: Department of Large Animal Clinical Sciences, Western College of Veterinary Medicine, University of Saskatchewan, Saskatoon, SK, Canada.
authors.forename: F J
authors.initials: FJ
authors.lastname: Marqués
authors.affiliation: Department of Large Animal Clinical Sciences, Western College of Veterinary Medicine, University of Saskatchewan, Saskatoon, SK, Canada.
authors.forename: S
authors.initials: S
authors.lastname: Higgins
authors.affiliation: Department of Large Animal Clinical Sciences, Western College of Veterinary Medicine, University of Saskatchewan, Saskatoon, SK, Canada.
authors.forename: R
authors.initials: R
authors.lastname: Chapuis
authors.affiliation: Department of Large Animal Clinical Sciences, Western College of Veterinary Medicine, University of Saskatchewan, Saskatoon, SK, Canada.
authors.forename: C
authors.initials: C
authors.lastname: Waldner
mesh_terms: D000818:Animals; D001774:Blood Chemical Analysis / Q000592:standards / Q000662:veterinary*; D001800:Blood Specimen Collection / Q000662:veterinary; D003422:Critical Care; D005189:False Positive Reactions; D005260:Female; D006736:Horses / Q000097:blood*; D007262:Infusions, Intravenous / Q000662:veterinary; D007552:Isotonic Solutions / Q000008:administration & dosage*; D007773:Lactates / Q000097:blood*; D008297:Male; D000077325:Ringer's Lactate
chemical_list: D007552:Isotonic Solutions; D007773:Lactates; D000077325:Ringer's Lactate
keywords: Blood collection; Clinical pathology; Critical care; Lactate metabolism; Monitoring; Reliability