The origins of the Lacto-Bolo reflex: the mythology of lactate in sepsis

Journal of Thoracic Disease
Rory SpiegelPaul E Marik

Abstract

The use of lactate as a marker of the severity of circulatory shock was popularized by Dr. Weil in the 1970's. Dr. Weil promoted the idea that blood lactate concentration increased in circulatory shock due to anaerobic metabolism following decreased oxygen delivery. This concept becomes entrenched with 1992 ACCP/SCCM consensus conference definition of sepsis. Since then, the central role of lactate in the definition and management of septic shock has only been expanded and become more ingrained. This review will discuss the wisdom of such an approach, an updated model describing the origins of hyperlactatemia in sepsis, and how such improvements in our knowledge of the underlying physiology should change our approach to resuscitation in patients presenting with septic shock.

Citations

Apr 26, 2020·Current Opinion in Critical Care·Jan Bakker, Can Ince
Dec 22, 2020·Frontiers in Medicine·Dagan O LonsdaleJeffrey Lipman
Apr 18, 2021·Emergency Medicine Clinics of North America·Kami M Hu, Robert M Brown
Sep 21, 2021·Seminars in Respiratory and Critical Care Medicine·Jeremy WeinbergerChanu Rhee

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