Anestéziológia a intenzívna medicína 1/2015

Lactate – marker of metabolic stress patients with critical illness

Hyperlactatemia is a strong independent predictor of mortality and morbidity in critical ill patient. Increased lactate level in plasma was widely believed as a marker of hypoperfusion and oxygen debt which leads to anaerobic glycolysis in cytosol. Base on this fact maneuvres to increase oxygen delivery was recommended. Furthermore decline of lactate level concentration has been recommended as an early endpoint of resuscitation of critical ill patient in sepsis. There is an evidence that hyperlactatemia is not only consequence of tissue hypoxia and anaerobic glycolysis. Data from experimental and human studies support the view that increased lactate level is as a part of activation of stress response.

Keywords: lactate, hyperlactatemia, sepsis, adrenerg stimulation.