Precision and accuracy of four handheld blood lactate analyzers across low to high exercise intensities

Purpose To evaluate the precision and accuracy in measured blood lactate concentrations among four commonly used handheld lactate analyzers compared to two stationary analyzers. Methods Venous blood samples were taken at exercise intensities ranging from low to high. The blood lactate concentration was measured simultaneously with four pairs of handheld lactate analyzers (two new units of each brand: Lactate Plus, Lactate Pro2, Lactate Scout 4, and TaiDoc TD-4289), and compared with two stationary analyzers (Biosen C-Line and YSI Sport 1500). Measurements were repeated for a range of blood lactate concentrations (measured with Biosen) from 0.88 to 4.89 mM with a median difference between measurements of 0.10 mM. Results The mean relative differences to the Biosen analyzer were - 7% (Plus), 7% (Pro), - 10% (Scout), 42% (Tai), and - 32% (Ysi). The residual standard errors after linear regression against Biosen were 0.18 mM (Plus), 0.20 mM (Pro), 0.22 mM (Scout), 0.15 mM (Tai), and 0.06 mM (Ysi). Accordingly, a blood lactate concentration of 3 mM measured with Biosen yielded 95% prediction intervals that were 0.72 mM (Plus), 0.80 mM (Pro), 0.87 mM (Scout), 0.60 mM (Tai), and 0.23 mM (Ysi) wide. Conclusion Compared to our two stationary analyzers, the precision of the four handheld lactate analyzers evaluated in this study was poor. Among the four, Tai was the most precise; however, this analyzer had low accuracy with a substantial mean difference to the reference analyzer.