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HelpTest Code 8168 Lactate/Pyruvate Panel, CSF
Performing Laboratory
St. Louis Children's Hospital
Last Reviewed
November 2024
Specimen Requirements
Specimen Type: Cerebrospinal Fluid (CSF)
Container/Tube
Preferred/Acceptable: Perchloric acid (PCA) Vacutainer® Call lab at 314-454-6130 for special PCA collection tube if needed.
Collection Volume: 1.0 mL
NOTE: minimum of 0.5 mL CSF may be used but MUST call lab to get an adjusted PCA tube for reduced volume collection.
Patient Preparation: None
Sample Rejection:
Specimens with incorrect volume of CSF to PCA ratio.
CSF specimens containing any red blood cells or hemolysis that are NOT mixed with PCA at collection site.
Mislabeled or unlabeled specimens.
Special Instructions:
1. Call lab at 314-454-6130 or 314-454-4268 to have PCA tube sent for collection.
2. Collect exactly 1.0 mL of CSF and place in PCA tube.
3. Invert tube 8-10 times to mix PCA and CSF.
4. Forward to lab promptly.
For outside facilities sending to lab: if specimen cannot be received at SLCH lab within 6 hours, refrigerate aliquot and send on wet ice.
Call Laboratory Medicine resident at digital pager 314-747-1320 for approval before drawing the specimen.
Call Barnes-Jewish Hospital Laboratory Customer Service at 314-362-1470 to obtain a perchloric acid (PCA) tube and to schedule a STAT pick-up.
Interpretive
Reference Range:
Lactate:
1.1-2.3 mmol/L
Pyruvate:
0.03-0.11 mmol/L
Critical Values:
Lactate:
Critical value (automatic callback): >8.0 mmol/L
Critical test results will be called initially and every 24 hours thereafter.
Limitations: This assay does not measure D(-) Lactate. The enzyme used is L(+) lactate dehydrogenase.
Methodology: Enzymatic
Additional Information
For SLCH Laboratory use only
Lab Processing instructions: Centrifuge specimen to separate any cellular components and aliquot into a conical tube. Refrigerate specimen if received after cut-off time.
For outside facilities sending to lab: Label aliquot as "PCA aliquot". If specimen cannot be received at SLCH lab promptly, refrigerate aliquot until able to send.
Processed Volume:
Remove all of the supernatant without getting any of the cellular components.
A minimum of 0.3 mL supernatant should be removed and placed in conical tube.
Analyte Stability:
Ambient: must be treated with PCA immediately
Refrigerated (PCA supernatant): Lactate 8 days /Pyruvate: 2 days
Frozen: do not freeze
NOTES:
1. Specimen may also be collected with 0.5 mL of CSF but MUST be added to and mixed in an adjusted PCA tube with only 1.0 mL of perchloric acid.
2. Reject if specimen to PCA ratio is not correct.
3. If CSF specimen is NOT placed in PCA tube at collection site, reject if specimen has any blood present. If clear, you may call Medical Director to see if able to add to PCA tube in lab.
Lab Dept
Core Lab
Logistics
Day(s) Test Set Up: Monday- Friday (results available day of testing)
Turnaround Time: 1-3 days
Lab Testing Section: Chemistry
General Information
Epic order name: Lactate and Pyruvate, CSF (EPIC Test# LAB5755)
Cerner order name: Lact/Pyruv CSF
CPT Codes:
83605: Lactate
84210: Pyruvate
LOINC Value:
Lactate: 2524-7
Pyruvate: 14121-8
Synonyms:
For BJH Laboratory Use Only
Laboratory Processing Instructions:BJH Chemistry will forward to the performing laboratory. Send immediately to St. Louis Children’s Hospital Laboratory. Wet Ice no longer required.