Lactate infusion as therapeutical intervention: a scoping review

Area of Science:

• Biochemistry and Metabolism
• Neuroscience
• Clinical Therapeutics

Background:

• Lactate is traditionally considered a metabolic waste product of anaerobic glycolysis.
• Emerging research highlights lactate's role as an alternative energy source for the brain and other organs.
• Current clinical practice has not widely adopted lactate infusion as a standard therapy.

Purpose of the Study:

• To review existing data on the therapeutic use of intravenous sodium lactate infusions in human patients.
• To assess the safety and potential benefits of lactate infusion in various pathological conditions.
• To identify gaps in research, particularly concerning pediatric applications.

Main Methods:

• A systematic literature search was conducted using PubMed and ClinicalTrials.gov up to November 2021.
• The search focused on interventional studies involving intravenous sodium lactate infusion in humans.
• Thirty-four articles were included, encompassing studies in adults with conditions such as diabetes mellitus, traumatic brain injury, Alzheimer's disease, and cardiac disease, plus one pediatric study.

Main Results:

• Intravenous sodium lactate administration was found to be safe, with no major reported side effects across the included studies.
• Evidence suggests potential benefits of therapeutic lactate infusion in specific pathological conditions, including traumatic brain injury.
• The reviewed literature indicates lactate's viability as an alternative energy source for the brain.

Conclusions:

• Sodium lactate is a safe alternative energy substrate for the adult brain.
• Therapeutic lactate infusion demonstrates potential benefits in certain clinical scenarios.
• Further research into the therapeutic effects of sodium lactate infusion in pediatric populations is warranted.