Clinical performance of amperometry compared with enzymatic ultra violet method for lactate quantification in cerebrospinal fluid
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Sérgio Monteiro de Almeida
,
Nagyla Barros
Abstract
Objectives
The differential diagnosis between acute bacterial meningitis (BM) and viral meningitis (VM) is crucial for treatment and prognosis. Cerebrospinal fluid (CSF) lactate (LA) is considered a good biomarker for differentiating BM from VM. The objective of this study was to compare the clinical performance of amperometry, which is not validated for measurement of LA in CSF samples, with a validated method (enzymatic ultra violet), for their ability to discriminate between acute BM and VM.
Methods
It was a retrospective, descriptive comparative study, 320 CSF reports were included; LA was quantified in CSF using either Dimension AR machine (Dade Behring) or amperometry (RAPID Point 500, Siemens). All samples with bacteria (n=54) or virus (n=139) identified, compared with a control with normal CSF (n=127).
Results
CSF LA levels were comparable for amperometry or enzymatic methods on each group studied, in a wide range of LA levels; it was capable to distinguish BM from VM independent of the method used to quantify.
Conclusions
The findings support the use of the amperometric method in measuring LA concentrations in CSF in a wide range of values. Amperometry is a less expensive method, validated for blood, easily available in small laboratories including in limited resources countries.
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Research funding: None declared.
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Author contributions: All authors have accepted responsibility for the entire content of this manuscript and approved its submission.
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Competing interests: Authors state no conflict of interest.
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Informed consent: Informed consent was obtained from all individuals included in this study.
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Ethical approval: The study was approved by the Institutional Review Board of the Hospital de Clinicas, Universidade Federal do Paraná, Brazil, and was done in compliance with the World Medical Association Declaration of Helsinki.
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© 2020 Walter de Gruyter GmbH, Berlin/Boston
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Artikel in diesem Heft
- Frontmatter
- Reviews
- An overview of mental health during the COVID-19 pandemic
- Potential mechanisms of action of convalescent plasma in COVID-19
- Mini Review
- Gap of knowledge in diagnosis of pyoderma gangrenosum in clinical specialties education
- Opinion Papers
- Learning clinical reasoning from the fictional detectives
- Integrating infection and sepsis management through holistic early warning systems and heuristic approaches: a concept proposal
- (F)utility of urine Bence Jones proteins for “routine” screening for plasma cell dyscrasia
- COVID-19 and the Le Chatelier’s principle
- Original Articles
- Are sniffer dogs a reliable approach for diagnosing SARS-CoV-2 infection?
- Using body temperature and variables commonly available in the EHR to predict acute infection: a proof-of-concept study showing improved pretest probability estimates for acute COVID-19 infection among discharged emergency department patients
- Identifying children at high risk for infection-related decompensation using a predictive emergency department-based electronic assessment tool
- Antecedent treat-and-release diagnoses prior to sepsis hospitalization among adult emergency department patients: a look-back analysis employing insurance claims data using Symptom-Disease Pair Analysis of Diagnostic Error (SPADE) methodology
- Rate of sepsis hospitalizations after misdiagnosis in adult emergency department patients: a look-forward analysis with administrative claims data using Symptom-Disease Pair Analysis of Diagnostic Error (SPADE) methodology in an integrated health system
- Real-world virtual patient simulation to improve diagnostic performance through deliberate practice: a prospective quasi-experimental study
- Overutilization and underutilization of autoantibody tests in patients with suspected autoimmune disorders
- Postnatal ultrasound follow-up in neonates with prenatal hydronephrosis
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- Case Report – Lessons in Clinical Reasoning
- Lessons in clinical reasoning – pitfalls, myths, and pearls: the contribution of faulty data gathering and synthesis to diagnostic error
- Case Report
- The COVID trap: pediatric diagnostic errors in a pandemic world
- Letters to the Editor
- Atrial arrhythmia and its association with COVID-19 outcome: a pooled analysis
- Serious game training in medical education: potential to mitigate cognitive biases of healthcare professionals
- Revisiting handoffs: an opportunity to prevent error
