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Blood lactate levels in sepsis: in 8 questions
Jean-Louis Vincent1, Jan Bakker2,3,4,5
1Department of Intensive Care, Erasme Hospital, Université libre de Bruxelles, Brussels, Belgium.
Purpose Of Review:
Blood lactate concentrations are frequently measured in critically ill patients and have important prognostic value. Here, we review some key questions related to their clinical use in sepsis.
Recent Findings:
Despite the metabolic hurdles, measuring lactate concentrations remains very informative in clinical practice. Although blood lactate levels change too slowly to represent the only guide to resuscitation, serial lactate levels can help to define the patient's trajectory and encourage a review of the therapeutic strategy if they remain stable or increase over time.
Summary:
Lactate concentrations respond too slowly to be used to guide acute changes in therapy, but can help evaluate overall response. Hyperlactatemia should not be considered as a problem in itself, but as a warning of altered cell function.