Lactate Dehydrogenase (LDH) Lab Values

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Abby Rose
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Outline

Objective:

Determine the significance and clinical use of LDH levels in clinical practice

 

Lab Test Name:

Lactate Dehydrogenase – LDH

 

Description:

LDH is important in making the body’s energy and is present in almost all of the tissues in the body such as the heart, lungs, blood, kidneys, and brain. 

When these tissues experience damage, the enzyme is released into the bloodstream or other body fluids.

 

Indications:

LDH is drawn to evaluate hemolysis, such as when patients are placed on ECMO or in some forms of anemia. 

It is also used to determine the presence of ischemia as those with cardiac cell damage will experience.

 

Normal Therapeutic Values:

Normal – 

  • 88-230 U/L

Collection:

  •  Plasma separator tube

 

What would cause increased levels?

Conditions that can cause increased LDH:

  • Liver disease
  • Pancreatitis
  • Anemia
  • Myocardial infarction
  • Bone fractures
  • Muscle trauma
  • Cancers
  • Infections 
    • encephalitis, bacterial meningitis, and HIV

 

What would cause decreased levels?

Typically, LDH deficiency is very rare, and usually not considered harmful.

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Transcript

Hey everyone, Abby, here from nursing.com. This lesson will discuss lactate dehydrogenase. We’ll talk about the normal levels and conditions that might increase or decrease its value. Let’s get started. 

 

Lactate Dehydrogenase or LDH, is a lab that measures the amount of LDH in the blood. LDH is present in almost every single tissue in the body. It gets released into the bloodstream when that tissue becomes damaged. We see that with myocardial infarction. 

 

Some clinical indications for having this lab drawn are in cases of hemolysis. I used to work with ECMO patients and through the oxygenator, as those cells would go through the motor and the whole circuit and everything, sometimes they would get really chewed up, and it was evidence of a lot of hemolysis, and so we would use that LDH value to tell us just how much that might be happening. It’s also indicated for patients with hemolytic anemia. It’s also going to be drawn to evaluate for ischemic organ damage like we talked about on that first slide. You can see here, after an MI, this section of tissue that became ischemic and died. Normal therapeutic values are between 88 and 230 units per liter. It’s collected in a plasma separator tube like this green top. 

 

When blood values are increased in LDH, that can indicate liver disease and pancreatitis. We talked about hemolytic disorders and myocardial infarction, but also bone fractures, muscle trauma, and let’s not forget anaerobic metabolism. It’s also one of the standard labs that are drawn when tumor lysis syndrome is suspected. In infections like encephalitis, bacterial meningitis, and HIV, an LDH value will also be increased. Now, it’s not very typical for there to be an LDH deficiency. It’s pretty rare and it’s not considered harmful or related to any disease process so, that’s some good news. LDH is an enzyme or byproduct of tissue damage that can be seen in anaerobic metabolism, hemolysis, MI, pancreatitis, liver, heart, brain, all of these various tissue diseases, right? It’s an indication of ischemia or damage. Normal values are between 88 and 230 units per liter. When it’s decreased, that’s pretty rare and unrelated to a disease process. 

 

Now, you all did great, and this wraps up our lesson on lactate dehydrogenase. Remember, we love you guys, now go out and be your best self today and as always, happy nursing.

References:

 

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Concepts Covered:

  • Circulatory System
  • Urinary System
  • Cardiovascular
  • Emergency Care of the Cardiac Patient
  • Cardiac Disorders
  • Nervous System
  • Skeletal System
  • Shock
  • Shock
  • Disorders of the Posterior Pituitary Gland
  • Endocrine
  • Disorders of Pancreas
  • Disorders of the Thyroid & Parathyroid Glands
  • Hematology
  • Gastrointestinal
  • Upper GI Disorders
  • Liver & Gallbladder Disorders
  • Newborn Complications
  • Lower GI Disorders
  • Multisystem
  • Neurological
  • Central Nervous System Disorders – Brain
  • Renal
  • Respiratory
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  • Noninfectious Respiratory Disorder
  • Hematologic Disorders
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  • Substance Abuse Disorders
  • Fetal Development
  • Terminology
  • Renal Disorders
  • Immunological Disorders
  • Pregnancy Risks
  • Proteins
  • Disorders of the Adrenal Gland
  • Newborn Care
  • Statistics
  • Respiratory Disorders
  • Emergency Care of the Neurological Patient
  • Neurological Emergencies
  • Basics of Sociology
  • Bipolar Disorders
  • Infectious Respiratory Disorder
  • Urinary Disorders

Study Plan Lessons

EKG (ECG) Course Introduction
01.01 CCRN Test Overview for CCRN Review
Electrical A&P of the Heart
Electrolytes Involved in Cardiac (Heart) Conduction
02.01 Hypertensive Crisis for CCRN Review
The EKG (ECG) Graph
02.02 Cardiomyopathy for CCRN Review
EKG (ECG) Waveforms
Calculating Heart Rate
02.03 Swan-Ganz Catheters for CCRN Review
02.04 Pulmonary Artery Wedge Pressure (PAWP) for CCRN Review
02.05 Calculating PAWP on PEEP for CCRN Review
02.06 Heart Murmurs for CCRN Review
02.07 Reading “A, C, V Waves” & PAWP Waveforms for CCRN Review
02.08 Cardiac Catheterization & Acute Coronary Syndrome for CCRN Review
02.09 12 Lead EKG- Leads 1, 2, 3, aVL, and aVF for CCRN Review
02.10 12 Lead EKG- Lead V1-V6 for CCRN Review
02.11 12 Lead EKG- Injuries for CCRN Review
02.12 Myocardial Infarction- Inferior Wall for CCRN Review
02.13 Myocardial Infarction – Anterior Septal Wall for CCRN Review
02.14 Shock Stages for CCRN Review
02.15 Hypovolemic Shock for CCRN Review
02.16 Cardiogenic Shock for CCRN Review
02.17 Septic Shock for CCRN Review
02.18 Cardiovascular Practice Questions for CCRN Review
Normal Sinus Rhythm
03.01 Syndrome of Inappropriate Antidiuretic hormone (SIADH) for CCRN Review
03.02 Diabetes Insipidus for CCRN Review
Sinus Bradycardia
03.03 Hypoglycemia for CCRN Review
Sinus Tachycardia
Atrial Flutter
03.04 DKA vs HHNK for CCRN Review
Atrial Fibrillation (A Fib)
03.05 Endocrine Practice Questions for CCRN Review
Premature Atrial Contraction (PAC)
Supraventricular Tachycardia (SVT)
Premature Ventricular Contraction (PVC)
Ventricular Tachycardia (V-tach)
Ventricular Fibrillation (V Fib)
1st Degree AV Heart Block
2nd Degree AV Heart Block Type 1 (Mobitz I, Wenckebach)
2nd Degree AV Heart Block Type 2 (Mobitz II)
3rd Degree AV Heart Block (Complete Heart Block)
04.01 Hematology for CCRN Review
04.02 Hematology Review Questions for CCRN Review
05.01 Pancreatitis and Large Bowel Obstruction for CCRN Review
05.02 Liver Overview and Disease for CCRN Review
05.03 Jaundice for CCRN Review
05.04 Ruptured Spleen for CCRN Review
05.05 GI Practice Questions for CCRN Review
06.01 Organ Failure, Dysfunction & Trauma for CCRN Review
06.02 Poisoning for CCRN Review
06.03 Multi-System CCRN Important Points for CCRN Review
06.04 Differentiating Ectopy and Aberrancy for CCRN Review
06.05 Wide Complex Tachycardia for CCRN Review
07.01 CVA (Cerebrovascular Accident/Stroke) for CCRN Review
07.02 Neuro Anatomy for CCRN Review
07.03 Uncal Herniation for CCRN Review
07.04 Supratentorial Herniation and Glasgow Coma Scale for CCRN Review
07.05 Supratentorial Herniation: Cushings Triad for CCRN Review
07.06 Increased Intracranial Pressure (ICP) for CCRN Review
07.07 Cerebral Perfusion Pressure for CCRN Review
07.08 Basilar Skull Fracture for CCRN Review
07.09 Meningitis for CCRN Review
07.10 Neurologic Review questions for CCRN Review
08.01 Psychological Review for CCRN Review
09.01 Acute Renal Failure Overview for CCRN Review
09.02 Acute Tubular Necrosis for CCRN Review
09.03 Acute Renal (Pre-Renal vs Renal) Failure for CCRN Review
09.04 Continuous Renal Replacement Therapy for CCRN Review
09.05 Chronic Renal Failure for CCRN Review
09.06 Renal Practice Questions for CCRN Review
10.01 Arterial Blood Gas (ABG) Interpretation for CCRN Review
10.02 Breath Sounds for CCRN Review
10.03 Acute Respiratory Failure for CCRN Review
10.04 Pulmonary Question Review for CCRN Review
Absolute Neutrophil Count (ANC) Lab Values
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Iron (Fe) Lab Values
Ischemic (CVA) Stroke Labs
Lab Panels
Lab Values Course Introduction
Lactate Dehydrogenase (LDH) Lab Values
Lipase Lab Values
Lithium Lab Values
Liver Function Tests
Mean Corpuscular Volume (MCV) Lab Values
Mean Platelet Volume (MPV) Lab Values
Methemoglobin (MHGB) Lab Values
Myoglobin (MB) Lab Values
Order of Lab Draws
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