Lactate: Difference between revisions
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==Background== | |||
*Byproduct of anaerobic metabolism | |||
*Serum lactate is a marker of tissue hypoperfusion and metabolic stress | |||
==Normal Values== | |||
*Normal: 0.5-2.0 mmol/L | |||
*Elevated (hyperlactatemia): 2.0-4.0 mmol/L | |||
*Severely elevated: >4 mmol/L | |||
==Interpretation== | |||
*Elevated lactate in the ED most commonly indicates tissue hypoperfusion ([[Sepsis|sepsis]], [[Shock|shock]], [[Cardiac arrest|cardiac arrest]]) | |||
*Lactate clearance (>10% decrease over 2-6 hours) is associated with improved outcomes in sepsis<ref>Jones AE, et al. Lactate clearance vs central venous oxygen saturation as goals of early sepsis therapy: a randomized clinical trial. JAMA. 2010; 303(8):739-746. PMID 20179283.</ref> | |||
*Type A (hypoxic): shock, cardiac arrest, mesenteric ischemia, severe hypoxemia, seizures, strenuous exercise | |||
*Type B (non-hypoxic): medications (metformin, epinephrine, albuterol), liver failure, thiamine deficiency, malignancy, [[DKA]] | |||
*Lactate >4 mmol/L in sepsis confers high mortality and qualifies as septic shock by Sepsis-3 criteria<ref>Singer M, et al. The Third International Consensus Definitions for Sepsis and Septic Shock (Sepsis-3). JAMA. 2016; 315(8):801-810. PMID 26903338.</ref> | |||
==See Also== | |||
*[[Lactic acidosis]] | |||
*[[Sepsis]] | |||
*[[Shock]] | |||
*[[Anion gap]] | |||
*[[BMP]] | |||
==References== | |||
<references/> | |||
[[Category:Labs]] | |||
Latest revision as of 06:58, 22 March 2026
Background
- Byproduct of anaerobic metabolism
- Serum lactate is a marker of tissue hypoperfusion and metabolic stress
Normal Values
- Normal: 0.5-2.0 mmol/L
- Elevated (hyperlactatemia): 2.0-4.0 mmol/L
- Severely elevated: >4 mmol/L
Interpretation
- Elevated lactate in the ED most commonly indicates tissue hypoperfusion (sepsis, shock, cardiac arrest)
- Lactate clearance (>10% decrease over 2-6 hours) is associated with improved outcomes in sepsis[1]
- Type A (hypoxic): shock, cardiac arrest, mesenteric ischemia, severe hypoxemia, seizures, strenuous exercise
- Type B (non-hypoxic): medications (metformin, epinephrine, albuterol), liver failure, thiamine deficiency, malignancy, DKA
- Lactate >4 mmol/L in sepsis confers high mortality and qualifies as septic shock by Sepsis-3 criteria[2]
See Also
References
- ↑ Jones AE, et al. Lactate clearance vs central venous oxygen saturation as goals of early sepsis therapy: a randomized clinical trial. JAMA. 2010; 303(8):739-746. PMID 20179283.
- ↑ Singer M, et al. The Third International Consensus Definitions for Sepsis and Septic Shock (Sepsis-3). JAMA. 2016; 315(8):801-810. PMID 26903338.