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Open Access Highly Accessed Review

Clinical use of lactate monitoring in critically ill patients

Jan Bakker1*, Maarten WN Nijsten2 and Tim C Jansen1

Author Affiliations

1 Department of Intensive Care Adults, Erasmus MC University Medical Center, PO Box 2040, Room H625, Rotterdam, CA 3000, Netherlands

2 Department of Critical Care, University of Groningen, University Medical Center, Groningen, Netherlands

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Annals of Intensive Care 2013, 3:12  doi:10.1186/2110-5820-3-12

Published: 10 May 2013

Abstract

Increased blood lactate levels (hyperlactataemia) are common in critically ill patients. Although frequently used to diagnose inadequate tissue oxygenation, other processes not related to tissue oxygenation may increase lactate levels. Especially in critically ill patients, increased glycolysis may be an important cause of hyperlactataemia. Nevertheless, the presence of increased lactate levels has important implications for the morbidity and mortality of the hyperlactataemic patients. Although the term lactic acidosis is frequently used, a significant relationship between lactate and pH only exists at higher lactate levels. The term lactate associated acidosis is therefore more appropriate. Two recent studies have underscored the importance of monitoring lactate levels and adjust treatment to the change in lactate levels in early resuscitation. As lactate levels can be measured rapidly at the bedside from various sources, structured lactate measurements should be incorporated in resuscitation protocols.