Blood test
Blood test

Lactic acid

Definition:
A test that measures the amount of lactic acid in the blood.

Alternative Names:
Lactate

How the test is performed:
Adult or child:
Blood is drawn from a vein (venipuncture), usually from the inside of the elbow or the back of the hand. The puncture site is cleaned with antiseptic, and a tourniquet (an elastic band) or blood pressure cuff is placed around the upper arm to apply pressure and restrict blood flow through the vein. This causes veins below the tourniquet to distend (fill with blood). A needle is inserted into the vein, and the blood is collected in an air-tight vial or a syringe. During the procedure, the tourniquet is removed to restore circulation. Once the blood has been collected, the needle is removed, and the puncture site is covered to stop any bleeding.

Infant or young child:
The area is cleansed with antiseptic and punctured with a sharp needle or a lancet. The blood may be collected in a pipette (small glass tube), on a slide, onto a test strip, or into a small container. Cotton or a bandage may be applied to the puncture site if there is any continued bleeding.
How to prepare for the test:
Do not exercise for several hours before the test.

Infants and children:
The physical and psychological preparation you can provide for this or any test or procedure depends on your child's age, interests, previous experience, and level of trust. For specific information regarding how you can prepare your child, see the following topics as they correspond to your child's age:
How the test will feel:
When the needle is inserted to draw blood, some people feel moderate pain, while others feel only a prick or stinging sensation. Afterward, there may be some throbbing.
Why the test is performed:

This test is usually used to see if lactic acid accumulation is causing acidosis (acidotic body state) symptoms.

Lactic acid is an intermediate product of carbohydratemetabolism and is derived mainly from muscle cells and red blood cells. During exercise, lactate levels may increase. However, the liver can normally metabolize more lactate than is produced and can return lactate levels to normal within a few hours.

Normal Values:
4.5 to 19.8 mg/dl (0.5-2.2 mmol/L)

Note: mg/dl = milligrams per deciliter; mmol/L = millimoles per liter
What abnormal results mean:
Severe oxygen deprivation of tissues results in a switch from aerobic to anaerobicmetabolism. Since lactate is the main product of anaerobic metabolism, it accumulates. Hypoxia seen in shock, congestive heart failure, or any other condition that would cause problems in oxygen being picked up by or transported in the blood, hepatic (liver) dysfunction, ischemia (not enough oxygenated blood getting to a certain area), and pulmonary (lung) insufficiency are all associated with increased serum lactate.
What the risks are:
  • excessive bleeding
  • fainting or feeling light-headed
  • hematoma (blood accumulating under the skin)
  • infection (a slight risk any time the skin is broken)
  • multiple punctures to locate veins
Special considerations:
Prolonged tourniquet time during venipuncture can artificially increase lactic acid level, as does fist clenching during venipuncture.

Veins and arteries vary in size from one patient to another and from one side of the body to the other. Obtaining a blood sample from some people may be more difficult than from others.

Review Date: 11/7/2001
Reviewed By: Jeffrey Heit, M.D., Department of Medicine, University of Pennsylvania Health System, Philadelphia, PA. Review provided by VeriMed Healthcare Network.
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