Blood lactate: biochemistry, laboratory methods, and clinical interpretation

Area of Science:

• Biochemistry
• Critical Care Medicine
• Physiology

Background:

• Lactate is a key indicator of circulatory impairment and tissue oxygenation.
• Understanding lactate homeostasis and biochemistry is crucial for clinical interpretation.
• Lactic acidosis is a significant concern in critically ill patients.

Purpose of the Study:

• To provide a comprehensive review of blood lactate measurements in critical care.
• To elucidate the interpretation of lactate levels in various clinical scenarios.
• To cover the latest developments in lactate measurement methodology.

Main Methods:

• Review of lactate homeostasis and biochemistry.
• Analysis of clinical interpretation of lactate measurements, including causes and treatments of hemodynamic deficits.
• Examination of lactate abnormalities classification and monitoring in critical care.
• Discussion of principles and developments in lactate methodology, including whole blood analyzers.

Main Results:

• Lactate measurements offer valuable insights into oxygenation status.
• Hemodynamic deficits can lead to lactic acidosis, requiring specific management.
• New whole blood analyzers represent advancements in lactate testing.

Conclusions:

• Accurate interpretation of lactate levels is essential for effective critical care.
• Guidelines for reference intervals and interpretation are provided.
• Lactate monitoring aids in surgical and critical care patient management.