Annals of Clinical Biochemistry > Volume 45, Number 2 > Pp. 177-183

This Article Figures Only Full Text Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Google Scholar Articles by Herrera, D. J. Articles by Griffiths, P. PubMed PubMed Citation Social Bookmarking                      What's this?

Original Article

Automated assay for plasma D-lactate by enzymatic spectrophotometric analysis with sample blank correction

Daniel Juan Herrera ¹ , Kevin Morris ², Chris Johnston ¹ and Paul Griffiths ¹

¹ Department of Clinical Chemistry; ² Intensive Care Unit, Birmingham Children's Hospital, Steelhouse Lane, Birmingham B4 6NH, UK

Corresponding author: Daniel Juan Herrera. Email: daniel.herrera{at}bch.nhs.uk

Background: D-lactate is essentially a product of bacterial metabolism, and its assessment in plasma has been mainly used to diagnose D-lactic acidosis in patients with short bowel syndrome. In the last few years, there has been growing interest in the use of subclinical elevations of D-lactate concentrations as a diagnostic tool in a variety of clinical conditions such as ischaemia, trauma or infection.

Methods: An endpoint enzymatic spectrophotometric assay to measure plasma D-lactate with a sample blank correction was validated on our routine clinical chemistry analyser (Olympus AU640). An ultrafiltration procedure was used in samples with a high L-lactate dehydrogenase (L-LDH) activity in order to avoid underestimation of the D-lactate concentration, when a sample blank was processed.

Results: The intra- and inter-assay imprecision were <5.1% and <13.3%, respectively and the mean recovery for the D-lactate assay was 95% (range 88–103%). Samples with L-LDH activity greater than 1500 IU/L required the use of ultrafiltration devices. Plasma D-lactate concentration in our ‘non-diseased’ paediatric population showed a non-Gaussian distribution – 95th percentile equal to 19 µmol/L – and no difference based on gender or age was observed.

Conclusion: We have established an accurate, sensitive and precise routine assay for D-lactate measurement in plasma. The assay was used to formulate paediatric reference ranges and will be used to assist clinicians to evaluate ‘D-lactate toxicity’ in patients with a variety of conditions such as short bowel syndrome, small bowel transplantation and as an early marker of intestinal ischaemia.

CiteULike    Complore    Connotea    Del.icio.us    Digg    Reddit    Technorati    What's this?