Lactic Acidosis in Sepsis: It's Not All Anaerobic: Implications for Diagnosis and Management.

Abstract:

:Increased blood lactate concentration (hyperlactatemia) and lactic acidosis (hyperlactatemia and serum pH < 7.35) are common in patients with severe sepsis or septic shock and are associated with significant morbidity and mortality. In some patients, most of the lactate that is produced in shock states is due to inadequate oxygen delivery resulting in tissue hypoxia and causing anaerobic glycolysis. However, lactate formation during sepsis is not entirely related to tissue hypoxia or reversible by increasing oxygen delivery. In this review, we initially outline the metabolism of lactate and etiology of lactic acidosis; we then address the pathophysiology of lactic acidosis in sepsis. We discuss the clinical implications of serum lactate measurement in diagnosis, monitoring, and prognostication in acute and intensive care settings. Finally, we explore treatment of lactic acidosis and its impact on clinical outcome.

journal_name

Chest

journal_title

Chest

authors

Suetrong B,Walley KR

doi

10.1378/chest.15-1703

subject

Has Abstract

pub_date

2016-01-01 00:00:00

pages

252-61

issue

1

eissn

0012-3692

issn

1931-3543

pii

S0012-3692(15)00016-1

journal_volume

149

pub_type

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