• View in gallery
    Figure 1—

    Comparison of lactate concentrations determined by use of an enzymatic-amperometric bedside system in jugular venous blood samples and capillary blood samples (obtained from a pinna) collected from 47 dogs. The data were compared by use of Passing-Bablock regression analysis; the correlation coefficient (r) between lactate concentrations measured from venous and capillary blood samples was 0.58 (slope = 2.0 [95% confidence interval, 1.5 to 3.0]; intercept, −1.2 [95% confidence interval, −3.1 to 0.4]). The solid line represents the regression line, the dashed lines represent the confidence interval for the regression line, and the dotted line represents the identity line (x = y).

  • View in gallery
    Figure 2—

    Bland-Altman plot to illustrate the limits of agreement for lactate concentrations determined by use of an enzymaticamperometric bedside system in jugular venous blood samples and capillary blood samples (obtained from a pinna) collected from 47 dogs. The mean difference between the 2 types of blood collection was 0.72 mmol/L (95% confidence interval, 0.38 to 1.06) with limits of agreement of −1.55 to 2.99 mmol/L. The dotted horizontal line represents the mean difference; the 2 dashed lines represent the limits of agreement (ie, mean difference ± 1.96 × SD of the differences).

  • 1.

    Lagutchik MS, Ogilvie GK, Hackett TB, et al. Increased lactate concentrations in ill and injured dogs. J Vet Emerg Crit Care 1998;8:117127.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 2.

    de Papp E, Drobatz KJ, Hughes D. Plasma lactate concentration as a predictor of gastric necrosis and survival among dogs with gastric dilatation-volvulus: 102 cases (1995–1998). J Am Vet Med Assoc 1999;215:4952.

    • Search Google Scholar
    • Export Citation
  • 3.

    Nel M, Lobetti RG, Keller N, et al. Prognostic value of blood lactate, blood glucose, and hematocrit in canine babesiosis. J Vet Intern Med 2004;18:471476.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 4.

    Matwichuk CL, Taylor S, Shmon CL, et al. Changes in rectal temperature and hematologic, biochemical, blood gas, and acid-base values in healthy Labrador Retrievers before and after strenuous exercise. Am J Vet Res 1999;60:8892.

    • Search Google Scholar
    • Export Citation
  • 5.

    Steiss J, Ahmad HA, Cooper P, et al. Physiologic responses in healthy Labrador retrievers during field trial training and competition. J Vet Intern Med 2004;18:147151.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 6.

    Ferasin L, Marcora S. A pilot study to assess the feasibility of a submaximal exercise test to measure individual response to cardiac medication in dogs with acquired heart failure. Vet Res Commun 2007;31:725737.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 7.

    Hughes D, Rozanski ER, Shofer FS, et al. Effect of sampling site, repeated sampling, pH, and PCO2 on plasma lactate concentration in healthy dogs. Am J Vet Res 1999;60:521524.

    • Search Google Scholar
    • Export Citation
  • 8.

    Ferasin L, Dodkin SJ, Amodio A, et al. Evaluation of a portable lactate analyzer (Lactate Scout) in dogs. Vet Clin Pathol 2007;36:3639.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 9.

    Acierno MJ, Mitchell MA. Evaluation of four point-of-care meters for rapid determination of blood lactate concentrations in dogs. J Am Vet Med Assoc 2007;230:13151318.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 10.

    Casella M, Wess G, Hässig M, et al. Home monitoring of blood glucose concentration by owners of diabetic dogs. J Small Anim Pract 2003;44:298305.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 11.

    Wess G, Reusch CE. Capillary blood sampling from the ear of dogs and cats and use of portable meters to measure glucose concentration. J Small Anim Pract 2000;41:6066.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 12.

    Casella M, Wess G, Reusch CE. Measurement of capillary blood glucose concentrations by pet owners: a new tool in the management of diabetes mellitus. J Am Anim Hosp Assoc 2002;38:239245.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 13.

    Bland JM, Altman DG. Statistical methods for assessing agreement between two methods of clinical measurement. Lancet 1986;1:307310.

  • 14.

    Knotzer H, Pajk W, Dunser MW, et al. Regional microvascular function and vascular reactivity in patients with different degrees of multiple organ dysfunction syndrome. Anesth Analg 2006;102:11871193.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 15.

    Williams JR, Armstrong N, Kirby BJ. The influence of the site of sampling and assay medium upon the measurement and interpretation of blood lactate responses to exercise. J Sports Sci 1992;10:95107.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 16.

    Foxdal P, Sjodin A, Ostman B, et al. The effect of different blood sampling sites and analyses on the relationship between exercise intensity and 4.0 mmol.l-1 blood lactate concentration. Eur J Appl Physiol Occup Physiol 1991;63:5254.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 17.

    Flohr JA, Womack CJ, Kovalcik PC. Comparison of capillary and venous blood lactate and glucose values during cycle ergometry. J Sports Med Phys Fitness 1996;36:261264.

    • Search Google Scholar
    • Export Citation
  • 18.

    Dassonville J, Beillot J, Lessard Y, et al. Blood lactate concentrations during exercise: effect of sampling site and exercise mode. J Sports Med Phys Fitness 1998;38:3946.

    • Search Google Scholar
    • Export Citation
  • 19.

    Nemec A, Pecar J, Seliškar A, et al. Assessment of acid-base status and plasma lactate concentrations in arterial, mixed venous, and portal blood from dogs during experimental hepatic blood inflow occlusion. Am J Vet Res 2003;64:599608.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 20.

    Cunningham DD, Henning TP, Shain EB, et al. Blood extraction from lancet wounds using vacuum combined with skin stretching. J Appl Physiol 2002;92:10891096.

    • Crossref
    • Search Google Scholar
    • Export Citation

Advertisement

Comparison of canine capillary and jugular venous blood lactate concentrations determined by use of an enzymatic-amperometric bedside system

Luca FerasinDepartment of Veterinary Clinical Sciences, College of Veterinary Medicine, University of Minnesota, Saint Paul, MN 55108.

Search for other papers by Luca Ferasin in
Current site
Google Scholar
PubMed
Close
 DVM, PhD
and
Thaibinh P. NguyenbaDepartment of Veterinary Clinical Sciences, College of Veterinary Medicine, University of Minnesota, Saint Paul, MN 55108.

Search for other papers by Thaibinh P. Nguyenba in
Current site
Google Scholar
PubMed
Close
 DVM

Abstract

Objective—To evaluate the analytical agreement between blood lactate concentrations determined by use of an enzymatic-amperometric bedside system in capillary blood samples from the pinna and in jugular venous blood samples from dogs.

Animals—53 dogs.

Procedures—For each dog, venous and capillary blood samples were obtained from a jugular vein and from the ear pinna (by use of a lancing device), respectively, following a randomized sequence of collection. Lactate concentrations in both types of samples were analyzed by use of an enzymatic-amperometric bedside system intended for lactate detection in capillary blood samples from humans that was previously validated in dogs. The Passing-Bablock regression analysis was used to compare venous and capillary blood lactate concentrations; the level of agreement was calculated by use of the Bland-Altman method.

Results—Jugular venous blood samples were collected without difficulty from all 53 dogs. A capillary blood sample was obtained from only 47 dogs. The correlation coefficient between lactate concentrations measured in venous and capillary blood samples was 0.58 (slope, 2.0 [95% confidence interval, 1.5 to 3.0]; intercept, −1.2 [95% confidence interval, −3.1 to 0.4]). The mean difference between methods was 0.72 mmol/L (95% confidence interval, 0.38 to 1.06) with limits of agreement of −1.55 to 2.99 mmol/L.

Conclusions and Clinical Relevance—Because of the lack of agreement between lactate concentrations determined in capillary and jugular venous blood samples, measurement of capillary blood lactate concentration in dogs performed with the technique used in the study does not appear to be a reliable alternative to jugular venous blood measurements.

Abstract

Objective—To evaluate the analytical agreement between blood lactate concentrations determined by use of an enzymatic-amperometric bedside system in capillary blood samples from the pinna and in jugular venous blood samples from dogs.

Animals—53 dogs.

Procedures—For each dog, venous and capillary blood samples were obtained from a jugular vein and from the ear pinna (by use of a lancing device), respectively, following a randomized sequence of collection. Lactate concentrations in both types of samples were analyzed by use of an enzymatic-amperometric bedside system intended for lactate detection in capillary blood samples from humans that was previously validated in dogs. The Passing-Bablock regression analysis was used to compare venous and capillary blood lactate concentrations; the level of agreement was calculated by use of the Bland-Altman method.

Results—Jugular venous blood samples were collected without difficulty from all 53 dogs. A capillary blood sample was obtained from only 47 dogs. The correlation coefficient between lactate concentrations measured in venous and capillary blood samples was 0.58 (slope, 2.0 [95% confidence interval, 1.5 to 3.0]; intercept, −1.2 [95% confidence interval, −3.1 to 0.4]). The mean difference between methods was 0.72 mmol/L (95% confidence interval, 0.38 to 1.06) with limits of agreement of −1.55 to 2.99 mmol/L.

Conclusions and Clinical Relevance—Because of the lack of agreement between lactate concentrations determined in capillary and jugular venous blood samples, measurement of capillary blood lactate concentration in dogs performed with the technique used in the study does not appear to be a reliable alternative to jugular venous blood measurements.

In veterinary medicine, there has been a growing interest in measurement of blood lactate concentration to assess the severity and prognosis of various critical medical and surgical conditions1–3 and evaluate exercise performance in both clinically normal dogs4,5 and dogs with congestive heart failure.6 In those studies, most of the lactate concentration measurements were performed on venous blood samples, primarily those obtained from the dogs' jugular veins. However, it has been reported7 that lactate concentrations vary among samples obtained from cephalic veins, jugular veins, and femoral arteries in dogs.

Recently, a portable lactate analyzera that is capable of performing measurements on a small volume sample (0.5 μL) has been validated for use in dogs,8,9 and this has raised the prospect of measuring lactate concentration in capillary blood samples obtained from the ear pinna by use of a lancing device. The potential advantages of analysis of capillary blood samples instead of venous blood samples are multiple. First, mechanical lancing devices are less invasive than venipuncture. Second, ear pricks are rarely associated with adverse effects, whereas venipuncture can occasionally be complicated by development of bruising or hematomas, especially after several consecutive venipuncture procedures. Third, previous studies10–12 have revealed that capillary blood samples can be obtained by owners to monitor blood glucose concentrations in dogs with diabetes mellitus. Similarly, capillary blood lactate measurements could be performed by dog trainers to evaluate the lactate concentration threshold of dogs during exercise. Finally, in emergency and critical care settings, capillary blood samples might be more easily collected than jugular venous samples in recumbent animals. The purpose of the study reported here was to evaluate the analytical agreement between blood lactate concentrations determined by use of an enzymatic-amperometric bedside system in capillary blood samples from the pinna and in jugular venous blood samples from dogs.

Materials and Methods

Animals—Fifty-three dogs that had been referred to the Veterinary Medical Center of the University of Minnesota were used in the study after receipt of written client consent. Study approval was granted by the Institutional Animal Care and Use Committee of the University of Minnesota.

Blood samples—Blood samples were obtained via a randomized sequence of collection (venous vs capillary sample) that was generated by an electronic spreadsheet.b For each dog, venous blood samples were obtained via venipuncture from a jugular vein by use of a 21-gauge disposable needle that was directly mounted onto a syringe. Capillary blood samples were collected from the inner (concave) surface of a pinna by use of a 3-finger technique described by Wess and Reusch11 (with the exclusion of the ear-warming phase involving a hairdryer) and a lancing device with 30-gauge disposable lancets.c The skin penetration level of the lancing system was set at the maximum value recommended by the manufacturer for obtaining suitable samples from areas with thick or calloused skin in humans. Prior to sample collection, the inner surface of the pinna was cleaned by delicate scrubbing with an alcohol pad. When a suitable sample volume (≥ 0.5 μL) was not obtained, the procedure was repeated for as many as 3 attempts. The time required to obtain both venous and capillary blood samples was no longer than 2 minutes for any dog.

Blood lactate concentration measurement—Lactate concentrations in venous and capillary blood samples were analyzed singly immediately after collection by use of an enzymatic-amperometric bedside system that was intended for lactate detection in human capillary blooda and that had been previously validated for use in dogs.8,9 The lactate analyzer was cleaned, calibrated, and operated in accordance with the manufacturer's instructions. For measurement of lactate concentration in venous blood, a drop of blood was deposited on a test strip directly from the syringe needle, immediately after sample collection. For measurement of lactate concentration in capillary blood, the small blood droplet obtained with the lancing device was transferred by gentle contact directly from the pinna to a test strip.

Statistical analysis—The comparison between venous and capillary lactate concentration values was performed via Passing-Bablock regression analysis. Level of agreement was calculated by use of a method described by Bland and Altman,13 in which bias is defined as the mean difference between the 2 methods and precision is the SD of the mean difference. Calculations were performed by use of clinical laboratory statistical software.d

Results

Jugular venous blood samples were obtained without difficulty from all 53 dogs. However, a capillary blood sample suitable for analysis was obtained from only 47 dogs; for 6 dogs, the lancing device failed to extract a suitable sample volume (≥ 0.5 μL). Adverse effects related to the use of the lancing device (development of excessive bleeding, bruising, or hematomas) were not evident, and none of the dogs appeared to resent the procedure.

The results of the comparison between the 2 types of blood collection were assessed in 2 graphical formats. By use of the Passing-Bablock regression analysis and the linear regression equation, the methods were compared (Figure 1). The correlation coefficient (r) between lactate concentrations measured from venous and capillary blood samples was 0.58 (slope = 2.0 [95% confidence interval, 1.5 to 3.0]; intercept, −1.2 [95% confidence interval, −3.1 to 0.4]).

Figure 1—
Figure 1—

Comparison of lactate concentrations determined by use of an enzymatic-amperometric bedside system in jugular venous blood samples and capillary blood samples (obtained from a pinna) collected from 47 dogs. The data were compared by use of Passing-Bablock regression analysis; the correlation coefficient (r) between lactate concentrations measured from venous and capillary blood samples was 0.58 (slope = 2.0 [95% confidence interval, 1.5 to 3.0]; intercept, −1.2 [95% confidence interval, −3.1 to 0.4]). The solid line represents the regression line, the dashed lines represent the confidence interval for the regression line, and the dotted line represents the identity line (x = y).

Citation: American Journal of Veterinary Research 69, 2; 10.2460/ajvr.69.2.208

The level of agreement was determined over the range of 1.05 to 5.45 mmol/L (Figure 2). The mean difference between the 2 types of blood collection was 0.72 mmol/L (95% confidence interval, 0.38 to 1.06) with limits of agreement of −1.55 to 2.99 mmol/L.

Figure 2—
Figure 2—

Bland-Altman plot to illustrate the limits of agreement for lactate concentrations determined by use of an enzymaticamperometric bedside system in jugular venous blood samples and capillary blood samples (obtained from a pinna) collected from 47 dogs. The mean difference between the 2 types of blood collection was 0.72 mmol/L (95% confidence interval, 0.38 to 1.06) with limits of agreement of −1.55 to 2.99 mmol/L. The dotted horizontal line represents the mean difference; the 2 dashed lines represent the limits of agreement (ie, mean difference ± 1.96 × SD of the differences).

Citation: American Journal of Veterinary Research 69, 2; 10.2460/ajvr.69.2.208

Discussion

The feasibility of obtaining capillary blood samples with a lancing device to measure glucose concentration in dogs and cats has been investigated.10–12 In those reports, the authors described the use of a vacuum-action lancing devicee to facilitate the formation of the blood drop following the ear puncture. In the present study, a suitable blood sample was obtained from approximately 90% of the dogs by use of a non–vacuum-assisted lancing device, and it is possible that a higher number of samples suitable for analysis may have been obtained by use of a vacuum-action lancing device. Application of warmth to the ear by use of a hairdryer to induce a local hyperemia before lancing appears to facilitate the formation of a blood drop after lancing.11 However, this procedure was deliberately omitted in our study to prevent possible distress in the dogs and avoid potential changes in tissue oxygen delivery and, consequently, changes in local lactate production.14

In the present study, the lactate concentrations measured in venous and capillary blood differed substantially. The low correlation coefficient determined via regression analysis (r = 0.58) suggested a weak linear association between the 2 techniques. Furthermore, the Bland-Altman plot revealed considerable, and clinically important, lack of agreement between lactate concentration measurements obtained from venous and capillary blood. Although a preliminary assessment of interoperator variability was not performed prior to the present study, the low coefficient of variation of lactate values measured by the portable lactate analyzer, both at low and high lactate concentrations,8 would suggest that the lack of agreement between venous and capillary technique was not caused by analytic variability.

Significant differences between lactate concentrations measured in venous blood samples and in capillary blood samples obtained from a fingertip have been detected in humans at rest but not during incremental treadmill exercise.15 Conversely, later studies16,17 revealed a significant difference in venous and capillary lactate concentrations during exercise, but not at rest.In another study18 conducted in humans, venous and capillary blood lactate concentrations during different types of exercise were compared; on the basis of the results, the investigators concluded that blood lactate concentration may differ depending on the sample collection site (antecubital vein, fingertip, or earlobe) and on the type of exercise (arm crank ergometer, bicycle ergometer, or treadmill).

In a study7 in dogs, different lactate concentrations were detected in blood samples obtained from cephalic veins, jugular veins, and femoral arteries. Significantly different lactate concentrations in samples obtained from the femoral artery, jugular vein, and portal vein were also identified in a study19 performed to determine the effects of extended hepatic blood flow occlusion in dogs. However, to the best of our knowledge, differences in venous and capillary blood lactate concentration have not been previously reported in dogs. Several factors may explain the different blood lactate concentrations determined from various sample collection sites. Blood lactate concentration depends on the balance of several factors: lactate production; lactate diffusion from muscle cells into blood; and lactate utilization by organs, such as the heart, liver, kidneys, and active and inactive skeletal muscles.18 Therefore, lactate concentrations would be expected to be greater in samples obtained from veins that transport blood from anatomic areas where lactate production is high (eg, active muscles or regions of hypoxemia); in contrast, venous lactate concentration would probably be lower in areas where lactate utilization is increased.

Additional factors may also affect lactate concentration in capillary blood. A capillary blood sample is composed of a mixture of arterial and venous blood, and conditions such as stasis or hyperemia may change the arterial component of the sample. Therefore, stasis and local hypoxemia induced by excessive compression at the base of a pinna might increase lactate production locally. Conversely, skin stretching can result in occlusion of venous capillaries, whereas arteries that supply the capillaries are less likely to be occluded20; under these circumstances, the arterial component of the capillary blood sample may increase and affect the lactate concentration measurement. A similar effect would be expected as a result of arterial dilation following skin scrubbing with alcohol. Finally, these factors might be exacerbated or diminished depending on the shape and size of the pinna, which vary considerably among different breeds of dog and may be associated with differences in microvascular architecture.

In the present study, the poor correlation and clinically important lack of agreement between ear capillary and jugular venous blood lactate concentrations in dogs determined by use of the portable lactate analyzer suggest that measurements of lactate concentration in capillary blood samples performed with this technique are not comparable to measurements in jugular venous blood samples. On the basis of this observation, it would be advisable to determine ranges of capillary blood lactate concentrations in clinically normal dogs before adopting this technique for clinical applications.

a.

Lactate Scout, Senslab, Leipzig, Germany.

b.

Microsoft Office Excel XP 2003, Microsoft Corp, Redmond, Wash.

c.

Comfort-lancing device FELIX, Senslab, Leipzig, Germany.

d.

Analyse-It Software Ltd, Leeds, UK.

e.

Microlet Vaculance, Bayer Diagnostics, Zurich, Switzerland.

References

  • 1.

    Lagutchik MS, Ogilvie GK, Hackett TB, et al. Increased lactate concentrations in ill and injured dogs. J Vet Emerg Crit Care 1998;8:117127.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 2.

    de Papp E, Drobatz KJ, Hughes D. Plasma lactate concentration as a predictor of gastric necrosis and survival among dogs with gastric dilatation-volvulus: 102 cases (1995–1998). J Am Vet Med Assoc 1999;215:4952.

    • Search Google Scholar
    • Export Citation
  • 3.

    Nel M, Lobetti RG, Keller N, et al. Prognostic value of blood lactate, blood glucose, and hematocrit in canine babesiosis. J Vet Intern Med 2004;18:471476.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 4.

    Matwichuk CL, Taylor S, Shmon CL, et al. Changes in rectal temperature and hematologic, biochemical, blood gas, and acid-base values in healthy Labrador Retrievers before and after strenuous exercise. Am J Vet Res 1999;60:8892.

    • Search Google Scholar
    • Export Citation
  • 5.

    Steiss J, Ahmad HA, Cooper P, et al. Physiologic responses in healthy Labrador retrievers during field trial training and competition. J Vet Intern Med 2004;18:147151.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 6.

    Ferasin L, Marcora S. A pilot study to assess the feasibility of a submaximal exercise test to measure individual response to cardiac medication in dogs with acquired heart failure. Vet Res Commun 2007;31:725737.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 7.

    Hughes D, Rozanski ER, Shofer FS, et al. Effect of sampling site, repeated sampling, pH, and PCO2 on plasma lactate concentration in healthy dogs. Am J Vet Res 1999;60:521524.

    • Search Google Scholar
    • Export Citation
  • 8.

    Ferasin L, Dodkin SJ, Amodio A, et al. Evaluation of a portable lactate analyzer (Lactate Scout) in dogs. Vet Clin Pathol 2007;36:3639.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 9.

    Acierno MJ, Mitchell MA. Evaluation of four point-of-care meters for rapid determination of blood lactate concentrations in dogs. J Am Vet Med Assoc 2007;230:13151318.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 10.

    Casella M, Wess G, Hässig M, et al. Home monitoring of blood glucose concentration by owners of diabetic dogs. J Small Anim Pract 2003;44:298305.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 11.

    Wess G, Reusch CE. Capillary blood sampling from the ear of dogs and cats and use of portable meters to measure glucose concentration. J Small Anim Pract 2000;41:6066.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 12.

    Casella M, Wess G, Reusch CE. Measurement of capillary blood glucose concentrations by pet owners: a new tool in the management of diabetes mellitus. J Am Anim Hosp Assoc 2002;38:239245.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 13.

    Bland JM, Altman DG. Statistical methods for assessing agreement between two methods of clinical measurement. Lancet 1986;1:307310.

  • 14.

    Knotzer H, Pajk W, Dunser MW, et al. Regional microvascular function and vascular reactivity in patients with different degrees of multiple organ dysfunction syndrome. Anesth Analg 2006;102:11871193.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 15.

    Williams JR, Armstrong N, Kirby BJ. The influence of the site of sampling and assay medium upon the measurement and interpretation of blood lactate responses to exercise. J Sports Sci 1992;10:95107.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 16.

    Foxdal P, Sjodin A, Ostman B, et al. The effect of different blood sampling sites and analyses on the relationship between exercise intensity and 4.0 mmol.l-1 blood lactate concentration. Eur J Appl Physiol Occup Physiol 1991;63:5254.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 17.

    Flohr JA, Womack CJ, Kovalcik PC. Comparison of capillary and venous blood lactate and glucose values during cycle ergometry. J Sports Med Phys Fitness 1996;36:261264.

    • Search Google Scholar
    • Export Citation
  • 18.

    Dassonville J, Beillot J, Lessard Y, et al. Blood lactate concentrations during exercise: effect of sampling site and exercise mode. J Sports Med Phys Fitness 1998;38:3946.

    • Search Google Scholar
    • Export Citation
  • 19.

    Nemec A, Pecar J, Seliškar A, et al. Assessment of acid-base status and plasma lactate concentrations in arterial, mixed venous, and portal blood from dogs during experimental hepatic blood inflow occlusion. Am J Vet Res 2003;64:599608.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 20.

    Cunningham DD, Henning TP, Shain EB, et al. Blood extraction from lancet wounds using vacuum combined with skin stretching. J Appl Physiol 2002;92:10891096.

    • Crossref
    • Search Google Scholar
    • Export Citation

Contributor Notes

Dr Nguyenba's present address is Medvet, 300 E Wilson Bridge Rd, Worthington, OH 43085.

The authors thank Christian Weyer (Senslab, Leipzig, Germany) for providing the test strips and the lancing device used in the study.

Address correspondence to Dr. Ferasin.