Contribution of arterial blood lactate measurement to the care of critically ill patients

American Journal of Clinical Pathology
C T AndersonM L Birnbaum

Abstract

Arterial blood samples from 202 critically ill patients were studied. Lactate concentration, PO2, PCO2, pH, oxygen saturation, total CO2, and toe temperature were measured. Base excess, buffer base, actual bicarbonate, and standard bicarbonate were calculated. Analysis of the initial data obtained from each patient revealed that lactate concentration alone could not be used to predict survival. Elevations in lactate concentrations were observed in all types of acid-base disturbances. Survival was lowest (30%) for patients in metabolic acidosis with respiratory compensation, mean lactate concentration 10.5 mEq/l (mmol/l), and highest (65%) for patients in uncompensated respiratory alkalosis, mean lactate concentration, 2.57 mEq/l (mmol/l). Knowing the type of acid-base disturbance is necessary to evaluate the significance of elevated blood lactate values.

References

Sep 8, 2005·Journal of Intensive Care Medicine·Pamela J Fall, Harold M Szerlip
Sep 1, 1987·Journal of Clinical Pathology·H B Stoner
Sep 2, 2008·Surgical Infections·Oliver L GunterJose J Diaz

Related Concepts

Buffers
Care of Intensive Care Unit Patient
Dioxygen
Lactate
Base Excess Measurement
Molecular Oxygen Saturation
Oxygen Saturation Measurement
Lactic Acid Measurement
Evaluation
Lactates

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