Elevated Lactate - What Does It Mean?
Physiology of Lactate
1. Anaerobic metabolism occurs when tissue does not have adequate oxygen to produce cellular energy from glycolosis via the more efficient Krebs cycle.
2. An end product of anaerobic metabolism is lactate
3. Lactate can be taken up by the liver, heart and kidneys and further metabolized to CO2 and ATP (energy)
Everyone with an elevated lactate does not have sepsis. Elevated lactate may occur from conditions causing:
1. Inadequate tissue perfusion
2. Increased production of lactate
3. Decreased metabolism of lactic acid
4. Inadequate tissue oxygenation
Examples of conditions that can cause elevated lactate:
1. Vigorous exercise or grand mal seizures (increased production)
2. Shock from causes other than sepsis, such as life threatening anemia, cardiogenic or neurogenic shock (reduced tissue perfusion)
3. Severe hypoxemia (increased production)
4. Cirrhosis or hepatic failure (decreased metabolism)
5. Drugs such s Nipride, Tylenol overdose, cyanide (increased production)
6. And many more!
