Scalp ph vs. scalp lactate

[Ron Heese]

Greetings to all,

I hope no one minds but this question is a bit more obstetrical in nature and if nothing else someone may be able to point me in a more apprpriate direction.

I am curious if anyone is using scalp lactate values rather than, or in conjunction with scalp ph, for fetal surveillance? In particular I am seeking out groups that are using the LactatePro handheld analyzer for this purpose. I have been collecting data for some time now and am considering research possibilities for the future.

One of the stumbling blocks I am confronted with is putting together an acceptable quality assurance program for this point of care (POCT) analyzer. Would anyone who uses this type of POCT be willing to share this type of information or direct me to someone who can? It would be most helpful and greatly appreciated. Any other discussion that is generated on the topic of using scalp lactate values is also very welcome.

If any group would like to e-mail me directly please feel free to do so at rheese@hsc.mb.ca I look forward to hearing from you.

Warmest regards

Ron Heese

Clinical Specialist, RRT

Children’s Respiratory Therapy.

Women’s and Child Health Program

Health Sciences Center

School of Medical Rehabilitation

University of Manitoba

(204) 787-2310 Pager 3009

rheese@hsc.mb.ca

[Stefan Johansson]

Hi! Our obstetric dept use scalp lactate and use lactate levels for decisions to perform emergency caesarean sections (toghether with other parameters like CTG).

I have no idea what equipment they use for their analyses, but it is a bedside technique as I understand it.

I will ask them about details (when I go on duty on Sunday again).

[Stefan Johansson]

Hi again.

I just checked the protocol for our delivery unit (about 6000 deliveries/y).

They use only scalp lactate (and not pH), and use the "Lactate Pro", manufactured by Arkray Inc, Japan.

The instrument is a "bedside" and very handy thing, about 5x5x1 cm.

Lactate levels used in decision-making are

• <4.2 normal
  
• 4.2-4.8 preacidotic / increased attention / repeated testing
  
• >4.8 acidotic, deliver asap!