Assessment of a point-of-care lactate monitor in emergency admissions of adult horses to a referral hospital

Background: Blood lactate concentration [LAC] is considered a useful indicator of disease severity in horses. Agreement of point-of-care (POC) lactate monitors with laboratory standards has not been established for clinically abnormal horses. Hypothesis: It was hypothesized that results from a POC lactate monitor would be in agreement with a laboratory-based measurement of [LAC]. Animals: The study included adult horses presented for emergency evaluation. Methods: A prospective observational study was performed. [LAC] was measured with whole blood (AWB) and plasma (APL) by means of a POC monitor (Accutrend) and compared with results from whole blood measured by a laboratory blood gas analyzer (NOVA). Results: Samples from 221 horses were used to compare the 2 lactate measurement techniques. Agreement (ρ ± SE) was closest between APL and NOVA (0.97 ± 0.01); an average observed difference of 0.15 ± 0.89 (mean ± SD) and 95% limits of agreement (LOA) -1.89, 1.59 also were found. Agreement was preserved and 95% LOA further decreased in horses with NOVA [LAC] of <5 mM and PCV <40%. Agreement was modest when testing whole blood samples on the POC monitor with increased 95% LOA. Conclusions and Clinical Importance: Results indicate close agreement between NOVA and the POC monitor when [LAC] was measured with plasma. Results were less consistent at higher [LAC] but sufficiently reliable to follow trends. Although whole blood may be used with the POC monitor to identify clinically important hyperlactatemia, results may be insufficiently reliable to monitor trends.