Lactate in Critically Ill Patients: At the Crossroads Between Perfusion and Metabolism

Abstract

Lactic acidosis is a common finding in critically ill patients, including patients with septic shock, cardiogenic or hypovolemic shock, trauma and liver failure [1–3]. In these conditions, hyperlactatemia occurs when production of lactic acid significantly exceeds lactate consumption. Lactate levels have been associated with patient outcomes in a large number of studies, either at patient admission or presentation or during the course of recovery [3–5]. In a study including more than 10,000 patients with septic shock, peak lactate concentration was associated with a near linear increase in patient mortality [6]. Outcome prediction was confirmed not only for absolute lactate values, but change in serum lactate levels was also independently associated with mortality [4].