Lactate dehydrogenase activity as measured by the SMAC is related to flow-cell energy

Determination of lactate dehydrogenase (LDH) activity in the SMAC (Technicon) is based on the change in NADH absorbance between two flow cells. We noted that results for patients' specimens and controls changed when the fiber optic terminations for the two LDH channel flow cells were adjusted or "peaked" at the colorimeter chopper assembly. The energy (intensity) of light reaching the flow cells was varied by adjusting the fiber optic terminations, and the absorbance readings for a series of solutions containing NADH and patients' specimens were recorded. For both flow cells, when the fiber optic terminations were adjusted to increase the zero absorbance light intensity from 20 lines to 60 lines, a significant (p less than 0.0001) proportional change was seen in the absorbance readings. Evidently the difference in absorbance between the two flow cells is related not only to the NADH concentrations but also to the difference in the light intensity at the two flow cells. Consequently, changes in the adjustment of the fiber optic terminations produce systematic changes in results for LDH in patients' sera. These systematic changes in LDH results may be minimized by maintaining equivalent settings of the fiber optic terminations for the two flow cells and by using the calibration material with an absorbance most similar to that of patients' specimens.