More on Hospital Blood Alcohol Tests

Ringer’s lactate solution may result in an artificially high hospital blood test result because of the reaction between lactate and LDH. Many hospital blood tests are performed upon suspects who have suffered trauma. In connection with trauma treatment, lactated Ringer’s solution is frequently injected intravenously to provide fluid to patients after blood loss. Lactated Ringer’s solution is also used as a conduit for the delivery of drugs to patients.  Lactate dehydrogenase (LDH) levels may monitor damage caused by muscle trauma or injury and to help identify hemolytic anemia. Hemolytic anemia is caused by the breakage of red blood cells – either because they are unusually fragile or because something is mechanically breaking them, such as an artificial heart valve. Elevated levels of LDH and changes in the ratio of the LDH isoenzymes usually indicate some type of tissue damage. Usually LDH levels will rise as the cellular destruction begins, peak after some time period, and then begin to fall. For instance, when someone has a heart attack, blood levels of total LDH will rise within 24 to 48 hours, peak in 2 to 3 days, and return to normal in 10 to 14 days. LDH levels are elevated in a wide variety of conditions reflecting itswidespread tissue distribution.

Elevated levels of LDH may be seen with:

• Cerebrovascular accident (CVA, stroke)

• Hemolytic anemias

• Pernicious anemias (megaloblastic anemais)

• Intestinal and pulmonary infarction

Many things can affect LDH results that are not necessarily a cause for concern. For example:

• Strenuous exercise can cause temporary elevations in LDH.

If your platelet count is increased, serum LDH will be artificially high and

not reflective of the LDH actually present.

A hospital blood alcohol analysis is performed by an enzyme assay. An enzyme is added to the serum sample. That enzyme (NAD) reacts in the presence of alcohol and forms another enzyme (NADH). The amount of one of NADH is then measured to determine the amount of alcohol in the sample. The problem lies in the contents of the ringers lactate.  The lactate reacts with LDH, which is often present in those who are injured or who are suffering from oxygen deprivation, to form pyvurate. During this process, additional NAD is converted to NADH which results in a falsely high alcohol result.

Written by Allen Trapp who is board certified by the National College for DUI Defense and the author of Georgia DUI Survival Guide Visit Website

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