Reliability and accuracy of six hand-held blood lactate analysers.

The reliability and accuracy of five portable blood lactate (BLa) analysers (Lactate Pro, Lactate Pro2, Lactate Scout+, Xpress™, and Edge) and one handheld point-of-care analyser (i-STAT) were compared to a criterion (Radiometer ABL90). Two devices of each brand of analyser were assessed using 22 x 6 mL blood samples taken from five subjects at rest and during exercise who generated lactate ranging ~1-23 mM. Each sample was measured simultaneously ~6 times on each device. Reliability was assessed as the within-sample standard deviation (wsSD) of the six replicates; accuracy as the bias compared with the ABL90; and overall error (the root mean squared error (√MSE)) was calculated as the square root of (wsSD(2) and bias(2)). The √MSE indicated that both the Edge and Xpress had low total error (~0-2 mM) for lactate concentrations <15 mM, whereas the Edge and Lactate Pro2 were the better of the portable analysers for concentrations >15 mM. In all cases, bias (negative) was the major contribution to the √MSE. In conclusion, in a clinical setting where BLa is generally <15 mM the Edge and Xpress devices are relevant, but for athlete testing where peak BLa is important for training prescription the Edge and Lactate Pro2 are preferred. Key pointsThe reliability of five common portable blood lactate analysers were generally <0.5 mM for concentrations in the range of ~1.0-10 mM.For all five portable analysers, the analytical error within a brand was much smaller than the biological variation in blood lactate (BLa).Compared with a criterion blood lactate analyser, there was a tendency for all portable analysers to under-read (i.e. a negative bias), which was particularly evident at the highest concentrations (BLa ~15-23 mM).The practical application of these negative biases would overestimate the ability of the athlete and prescribe a training intensity that would be too high.

Evaluation of three portable blood lactate analysers: Lactate Pro, Lactate Scout and Lactate Plus.

Three portable blood lactate analysers, Lactate Pro (LP), Lactate Scout (LS) and Lactate Plus (L(+)), were evaluated. Analyser reliability and accuracy was assessed. For reliability, intra- and inter-analyser comparisons demonstrated that the LP (intra-TE = 0.5 mM, inter-TE = 0.4 mM) and L(+) (intra-TE = 0.4, inter-TE = 0.4 mM) displayed greater overall reliability than the LS (intra-TE = 1.0, inter-TE = 0.8 mM). At BLa < 4.0 mM, the LP (intra-TE = 0.1 mM) demonstrated greater reliability than the LS (intra-TE = 0.5 mM) and L(+) (intra-TE = 0.4 mM). At BLa > 8.0 mM, the LP (intra-TE = 0.5 mM, inter-TE = 0.4 mM) and L(+) (intra- and inter-TE = 0.4 mM) displayed greater reliability than the LS (intra-TE = 1.1 mM, inter-TE = 0.9 mM). For accuracy, the L(+) (SEE = 0.6 mM) compared more favourably to the LP than the LS (SEE = 1.1 mM). At BLa approximately 1.0-18.0 mM, the LS produced values that were up to 0.9 mM higher than the LP; the L(+) produced BLa that were within +/-0.1 mM. All portable analysers tended to under-read the ABL 700 analyser. The suitability of the LP and L(+) as accurate analysers is supported by strong correlations (r = 0.91 and r = 0.94) and limits of agreement