Lactate/Lactic Acid: Why Do We Check It and Why Do We Trend it?

Saving Lives Podcast: Critical Care w/eddyjoemd

In this podcast I cover lactate levels (aka lactic acid levels) sorting out the original data as to why we check it on every patient with sepsis or septic shock upon arrival to the ED, how it is associated with mortality, and how trending it could provide insight to the prognosis of our patients. In this episode, we explore the importance of lactate/lactic acid levels in critically ill patients. Why do we check lactate levels? What do they tell us about a patient's clinical status? How do we interpret trends in lactate levels over time? We'll discuss the physiology behind lactate production, its role in sepsis and shock, and how it can help guide our resuscitation efforts. Join us as we dive into the world of lactate and its crucial role in critical care.

Show Notes: https://eddyjoemd.com/lactic-acid-sepsis/

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Citations:
Spiegel R, Gordon D, Marik PE. The origins of the Lacto-Bolo reflex: the mythology of lactate in sepsis. J Thorac Dis. 2020 Feb;12(Suppl 1):S48-S53. doi: 10.21037/jtd.2019.11.48. PMID: 32148925; PMCID: PMC7024759.

Mikkelsen ME, Miltiades AN, Gaieski DF, Goyal M, Fuchs BD, Shah CV, Bellamy SL, Christie JD. Serum lactate is associated with mortality in severe sepsis independent of organ failure and shock. Crit Care Med. 2009 May;37(5):1670-7. doi: 10.1097/CCM.0b013e31819fcf68. PMID: 19325467.

Nguyen HB, Rivers EP, Knoblich BP, Jacobsen G, Muzzin A, Ressler JA, Tomlanovich MC. Early lactate clearance is associated with improved outcome in severe sepsis and septic shock. Crit Care Med. 2004 Aug;32(8):1637-42. doi: 10.1097/01.ccm.0000132904.35713.a7. PMID: 15286537.

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