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Lactic acid kinetics in respiratory alkalosis
W Druml1, G Grimm, A N Laggner
11st Department of Medicine, University of Vienna, Austria.
Critical Care Medicine
|September 1, 1991
Summary
Respiratory alkalosis significantly elevates plasma lactate levels and impairs the body's ability to clear infused lactic acid. This study highlights the detrimental effects of alkalosis on lactate metabolism.
Area of Science:
- Critical Care Medicine
- Physiology
- Biochemistry
Background:
- Lactate accumulation is a critical indicator in critically ill patients.
- Understanding factors affecting lactate elimination is crucial for patient management.
Purpose of the Study:
- To investigate the impact of respiratory alkalosis on the elimination kinetics of intravenously infused lactate.
- To determine how induced respiratory alkalosis affects basal lactate levels and lactate clearance.
Main Methods:
- A prospective, randomized, crossover study was conducted in a medical intensive care unit.
- Eight patients receiving ventilatory support underwent lactate infusion during normoventilation and induced respiratory alkalosis.
- Lactate elimination was assessed using a two-compartment model after L-lactic acid infusion.
Main Results:
- Respiratory alkalosis significantly increased basal plasma lactate concentrations.
- The lactate elimination half-life (both alpha and beta) was prolonged under respiratory alkalosis.
- Whole-body lactate clearance decreased by approximately 40% during respiratory alkalosis.
Conclusions:
- Respiratory alkalosis adversely affects lactate metabolism by increasing basal lactate levels and reducing lactate clearance.
- These findings underscore the negative consequences of alkalosis in patients with altered lactate dynamics.