What is the unit of measurement for normal lactate on the Gem 5000 (GEM Premier 5000 analyzer)?

Normal Lactate Unit of Measurement on the GEM Premier 5000 Analyzer

The normal range for serum lactate on the GEM Premier 5000 analyzer is ≤2 mmol/L. 1

Understanding Lactate Measurement and Normal Values

• The GEM Premier 5000 analyzer reports lactate values in millimoles per liter (mmol/L), with normal values being ≤2 mmol/L 1
• Values above 2 mmol/L are considered elevated and potentially indicative of tissue hypoperfusion or other pathological processes 1
• This normal range is consistently referenced across multiple critical care guidelines and research studies 2

Clinical Significance of Lactate Values

• Lactate levels are categorized into ranges that correlate with clinical outcomes:

  • Normal: ≤2 mmol/L 1, 3
  • Intermediate elevation: 2.1-3.9 mmol/L 4
  • High/severe elevation: ≥4 mmol/L 4

• Mortality risk increases linearly with lactate levels:

  • Normal range (≤2 mmol/L): 15% in-hospital mortality 4
  • Intermediate range (2.1-3.9 mmol/L): 25% in-hospital mortality 4
  • High range (≥4 mmol/L): 38% in-hospital mortality 4

Lactate Clearance and Prognostic Value

• Lactate clearance (return to normal range of ≤2 mmol/L) within 24 hours is associated with 100% survival in trauma patients 2
• Delayed normalization (>24 hours) correlates with development of post-traumatic organ failure 2
• Persistent elevation >48 hours is associated with only 13.6% survival 2

Comparison with Base Deficit

• Both lactate and base deficit are recommended as sensitive tests to estimate and monitor the extent of bleeding and shock (Grade 1B recommendation) 2
• Base deficit is measured in milliequivalents per liter (mEq/L) 2
• Base deficit is stratified into:
  • Mild: -3 to -5 mEq/L 2
  • Moderate: -6 to -9 mEq/L 2
  • Severe: <-10 mEq/L 2

Clinical Applications

• An initial lactate ≥4 mmol/L substantially increases the probability of acute-phase death 4
• Even lactate levels within the normal range (1.4-2.3 mmol/L) have prognostic value and can indicate increased mortality risk compared to very low levels (≤1.4 mmol/L) 5, 6
• Lactate ≥4 mmol/L in hemodynamically normal trauma patients is a robust predictor of massive transfusion requirements 7

Important Considerations

• Proper sample handling is critical for accurate lactate results, including use of appropriate collection tubes and timely processing 1
• Confounding factors that can elevate lactate include alcohol consumption, cerebral hypoxia/ischemia, and vascular compromise 1
• Serial lactate measurements provide better prognostic information than single measurements 2