Podcast #110:  Elevated Lactate


lactate-plus-is-a-highly-recommended-analyzer-both-in-a-clinical-and-athletic-setting-1Run Time:
 3 minutes

Author:  Susan Brion M.D.

Educational Pearls:

  • Not all that is elevated lactate is sepsis.
  • Lactate is produced under anaerobic conditions whenever there is any state of hypoperfusion or hypermetabolic state. It is produced by all tissues, most prominently by muscle tissue, and is cleared by the liver.
  • A normal level can be anywhere from 2 to 2.5, and an elevated lactate is generally caused by an increase in production of lactate, decreased clearance of lactate, or both. A decrease in the enzyme cofactors, like thiamine, can also elevate a lactate and is often seen in alcoholics.
  • Etiologies of an elevated lactate include sepsis, septic shock, undifferentiated shock, trauma, seizure, increase in muscle activity, severe asthmatics, regional ischemia, burns, smoke inhalation, DKA, thiamine deficiency, liver dysfunction, malignancy, and a long list of medications including metformin, epinephrine, extended use of propofol, Tylenol overdose, and beta2 agonists.

Link to Podcast: http://medicalminute.madewithopinion.com/elevated-lactate/

References: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3975915/

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