Beyond D-lactic acidosis: interpreting D-lactate after pediatric intestinal failure
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Updated: Nov 5, 2026

Measuring Lactase Enzymatic Activity in the Teaching Lab
Published on: August 6, 2018
1Centre for the Studies of Asphyxia and Resuscitation, Royal Alexandra Hospital, Edmonton, AB, Canada. georg.schmoelzer@me.com.
Impact:
This commentary examines D-lactate beyond overt acidosis in children recovering from intestinal failure. Higher D-lactate after enteral autonomy suggests persistent metabolic differences but does not establish successful intestinal adaptation. Interpretation requires consideration of intestinal anatomy, nutrition, microbial fermentation, host metabolism, and renal handling. Preliminary pediatric reference values and urinary measurements require further validation before informing clinical decisions. Longitudinal studies should determine whether D-lactate predicts meaningful outcomes and improves care during intestinal rehabilitation.
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