Lactate Gap Associated with Ethylene Glycol

Situation:

(1) lactate concentration by a point-of-care (POC) device is very high

(2) lactate concentration by a laboratory analyzer shows a lactate level that is much lower, often within the normal range

Mechanism:

(1) point-of-care devices often use lactate oxidase from bacteria with amperometric detection

(2) chemical analyzers often use LDH with colorimetric detection

lactate gap =

= (lactate value by the POC device) - (lactate value by the laboratory analyzer)

Alternatively, the POC result can be divided by the laboratory result to give a multiple.

The gap is affected by the methods used. Therefore, the finding is a qualitative clue and cannot be used to estimate concentration of glycolate or glyoxylate.