Increased pyruvic acid levels have been associated with diabetes mellitus, vitamin deficiencies, uremia, congestive heart failure, liver diseases, muscular dystrophy, thiamine deficiency, and neoplastic conditions.

Pyruvic acid is useful in assessing oxygen deprivation and provides an index of the severity of circulatory failure.

Patient should be in a fasting and resting state (should not exercise).

Grey Sodium flouride (NaFl)

Tube should be pre-chilled prior to sample collection

• Draw blood into chilled gray-top tube
• Immediately following collection, mix sample thoroughly by gently inverting 8 - 10 times to prevent clotting

1. Immediately after blood is drawn, add 2 mL of whole blood from the gray-top tube to 2 mL of 8% perchloric acid (7 mL of 70% perchloric acid diluted to 100 mL with deionized water). Perchloric acid tube   
   1. Use 1:1 blood (ie, equal parts) to 8% perchloric ratio if less blood is obtained.
2. Shake mixture vigorously for about 30 seconds.
3. Refrigerate for five minutes to ensure complete protein precipitation.
4. Centrifuge 5 to 10 minutes at approximately 1500xg.
5. Immediately transfer the CLEAR SUPERNATANT to a Transfer vial/tube with cap - 12mL (LabCorp).
   1. A second centrifugation of the supernatant may be necessary to obtain a clear protein-free solution.
6. Label the transport tube as "SUPERNATANT" and send to the laboratory.

Transfer vial/tube with cap - 12mL (LabCorp)

Refrigerated (preferred) - 7 days

Ambient - 5 days

Frozen - 7 days

Freeze/thaw cycle - stable x3

• Whole blood received
• Grey-top tube not prepared with perchloric acid

Pyruvate - lactate; spectrophotometry

0.3 - 0.7 mg/dL