Lactate

So when people talk about patients having a high lactate we think about them being sick, it can at times be easy to slip into thinking that this equals sepsis or maybe ischaemia. And whilst the presence of a high lactate in the context of infection and ischaemia is important to note, there is a lot more to interpreting a raised lactate than may first be apparent… So in this episode we’re going to delve down into lactate, have a think about what it is, what normal and raised levels are, consider the mechanisms behind it’s formation and breakdown and think about the causes of raised lactate. We’ll then put this all together and have a think about how we can interpret and lactate levels ensuring we give the best treatment to our patients! Enjoy!

Simon, Rob & James

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References

Etiology and therapeutic approach to elevated lactate. Lars W. Andersen. Mayo Clin Proc. 2013

Lactate physiology in health and disease. Phypers. Continuing Education in Anaesthesia Critical Care & Pain. 2006

Initial pH, base deficit, lactate, anion gap, strong ion difference, and strong ion gap predict outcome from major vascular injury. Kaplan. Crit Care Med. 2004

Clinical practice guideline: endpoints of resuscitation. Tisherman. The Journal of trauma. 2004

Etiology and therapeutic approach to elevated lactate. Lars W. Andersen. Mayo Coin Proc. 2014

Determinants of prehospital lactate in trauma patients: a retrospective cohort study. E Ter Avest. BMC Emerg Med. 2020

St. Emlyns; Lacthate

Understanding elevated lactate; Resus.Me

Lactate and lactic acidosis; LITFL

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