Serial Lactate in Clinical Medicine - A Narrative Review.

Area of Science:

• Clinical Medicine
• Biochemistry
• Medical Technology

Background:

• Blood lactate is a crucial diagnostic, therapeutic, and prognostic guide in clinical medicine.
• Publication rates on lactate have increased tenfold in the past decade, highlighting its growing importance.
• Lactate monitoring is evolving from single to serial measurements for assessing treatment response.

Purpose of the Study:

• To scrutinize the utility of serial lactate measurements in clinical practice.
• To explore the potential of wearable lactate sensors and their integration with electronic health records and early warning scores.
• To review the current literature on serial lactate measurements and lactate clearance.

Main Methods:

• Systematic literature search of MEDLINE, PubMed, and EMBASE using keywords: "lactate", "serial", "point of care", "clearance", "prognosis", and "clinical".
• Publications were vetted by authors specializing in anesthesiology, intensive care, trauma, emergency medicine, obstetrics, pediatrics, and general hospital medicine.
• Manuscript compilation involved multidisciplinary groups focused on underlying pathology.

Main Results:

• The clinical utility of lactate as a dynamic parameter is increasingly recognized.
• Recent publications emphasize the value of serial lactate measurements in guiding therapy.
• Lactate level acquisition can be challenging and delayed outside of acute care settings (ER, OR, ICU).

Conclusions:

• Serial lactate measurements and lactate clearance provide regular feedback on therapeutic response and patient status.
• Wearable lactate devices integrated into early warning scores can facilitate earlier identification of deteriorating patients on hospital wards.
• This approach may alleviate the burden on nursing staff for continuous patient observation.