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Sepsis and Lactic Acid, Plasma Normal Range

In consultation with Quality & Patient Safety, and the Sepsis Task Force, the Department of Pathology & Laboratory Medicine will update the normal range for Lactic Acid, Plasma to 0.5 - 2.0 mmol/L. Values greater than 2.0 mmol/L will be flagged as abnormal and the following comment will appear:

Sepsis screening alert:

  • If initial lactate > 2.0 mmol/L, repeat level within 2 hours and consider severe sepsis.
  • If initial lactate > or = 4.0 mmol/L, repeat level within 2 hours and consider possible septic shock.

Effective date: May 29, 2019

As a reminder, if there is concern for sepsis, severe sepsis or septic shock, the Sepsis Task Force recommends to complete the following tasks within 3 hours in accordance with Centers for Medicare & Medicaid Services Severe Sepsis/Septic Shock: Management Bundle:

  • Blood culture, 2 sets (prior to start of antibiotics) [NOTE: Obtain 10mL per bottle]

  • Broad-spectrum intravenous antibiotics

  • Bolus 30ml/kg of crystalloid fluid (if SBP <90mmHg or lactate ≥4.0 mmol/L)

  • Documentation of date/time of onset of sepsis, severe sepsis or shock, any patient or family refusal of care, and response to fluid bolus if administered.

If sepsis was initially considered as a diagnosis causing clinical symptoms but later ruled out, clearly document that in the medical record.

Antimicrobial therapy guidelines for severe sepsis/septic shock may be found on the intranet: 

Specimen requirement and testing information:

Specimen: Collect 4.0 mL whole blood in a grey-top tube (Sodium Fluoride/Potassium Oxalate). Invert tube 8-10 times to properly mix. Improper or delayed mixing may affect results. Do not shake. Spin down and separate plasma from cells within 2 hours of sample collection. Blood should be drawn from a stasis-free vein.

Test methodology: Enzymatic

Test code: LACTAT



Uncentrifuged whole blood:
Ambient: 2 hours
Refrigerated: 2 hours
Frozen: Unacceptable

Plasma, after centrifugation and aliquot separated from cells:
Ambient: N/A
Refrigerated: 2 weeks

Frozen: 1 month

Turnaround time (TAT):

STAT: 60 minutes
Routine: 2-4 hours
Set Up Days: Daily

Specimen required: 1.0 mL plasma
Minimum volume: 0.5 mL plasma

Rejection criteria:

Specimens that exceed stated stability, unlabeled/mislabeled/mismatched specimens, specimens submitted in leaking containers, grossly hemolyzed specimens

References: Click here ›

A summary of all tests offered by our laboratory services can be found here:


Bridgit O. Crews, PhD, DABCC
Clinical Chemistry & Toxicology

Sonali Iyer, MD
Medical Director
Sepsis Task Force

Edwin S. Monuki, MD, PhD
Department of Pathology & Laboratory Medicine

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