Peptidoglycan and lipoteichoic acid,components of the streptococcal cell wall,have marked and differential effects on adhesion molecule expression and the production of reactive oxygen species in human whole blood leukocytes

Objective: To investigate whether lactate levels may vary in relation to time, substrate concentration and blood cells counts. Methods: In this study 110 samples from the daily clinical routine blood samples were collected. Determinations of lactate were made at different times where the samples had not been left for more than 120?min at room temperature (24°C) or in the fridge (4°C). The influence of glucose and blood cells on lactate production was also estimated. The rate in change of concentration (slope) and the increase expected at the beginning (intercept) were estimated through linear regression using a longitudinal marginal method. Results: The time‐related change in lactate was significantly higher at room temperature (0.012?mmol?L^?1?min^?1) than at 4°C (0.0035?mmol?L^?1?min^?1) (p<0.0001). There was a significantly positive relationship between blood cells (mainly leucocytes) and the rate of reaction at room temperature. Conclusions: A delay in the processing of a whole blood sample of more than 15?min at room temperature or an hour in the fridge entails an important overestimation of the initial lactate levels. Pronounced leucocytosis (higher than 6×10¹⁰/L) meaningfully cut down the stability period (10?min).