Comparison of pH, lactate, and glucose analysis of equine synovial fluid using a portable clinical analyzer with a bench-top blood gas analyzer.
Authors: Dechant Julie E, Symm William A, Nieto Jorge E
Journal: Veterinary surgery : VS
Summary
# Editorial Summary When evaluating joint health through synovial fluid analysis, clinicians must choose between portable point-of-care analysers and laboratory-based equipment, each with different implications for rapid decision-making versus analytical precision. Dechant and colleagues prospectively compared a portable i-STAT analyser against a bench-top ABL 705 analyser across 34 synovial fluid samples from horses ranging from neonates to 24-year-olds, including both clinically normal joints and those with suspected sepsis. Lactate and glucose measurements showed excellent agreement between devices (concordance correlation coefficients of 0.97 and 0.96 respectively, with minor biases of 0.198 mmol/L and 9 mg/dL), but pH analysis proved problematic, with a concordance coefficient of only 0.89 and a systematic bias of −0.057 units. For practitioners relying on synovial fluid biomarkers to guide septic arthritis diagnosis and prognosis, the portable analyser offers dependable lactate and glucose values suitable for field use or rapid clinic-side assessment, though pH interpretation should be interpreted cautiously or confirmed using laboratory analysis if clinical decisions hinge critically on this parameter.
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Practical Takeaways
- •The i-STAT portable analyzer can reliably replace laboratory analysis for lactate and glucose in synovial fluid samples, enabling faster joint sepsis assessment in the field or clinic
- •Do not rely on portable analyzer pH readings for synovial fluid—send samples to the laboratory for accurate pH values if this parameter is critical to your clinical decision
- •This method validation supports point-of-care testing as a practical alternative for two of three key synovial fluid parameters in lameness and joint disease cases
Key Findings
- •Portable i-STAT analyzer showed acceptable agreement with bench-top ABL 705 for lactate concentration (concordance correlation coefficient 0.97, bias 0.198 mmol/L)
- •Portable analyzer showed acceptable agreement for glucose concentration (concordance correlation coefficient 0.96, bias 9 mg/dL)
- •pH measurement agreement was not acceptable between analyzers (concordance correlation coefficient 0.89, bias -0.057)
- •Portable clinical analyzer is suitable for field-based lactate and glucose evaluation in equine synovial fluid but not for pH assessment