emDocs - February 5, 2015 - By Tyler Hurst DO and Christopher Doty MD
(Residency Physician and Program Director, respectively, for University of Kentucky Emergency Medicine Residency Program)
Edited by Alex Koyfman MD and Stephen Alerhand MD
"Background:
Lactate was first proposed as a prognostic biomarker in 1964 by Broder and Weil who observed that a lactate excess of >4 mmol/L was associated with poor outcomes in patients with undifferentiated shock.
After the Rivers Trial, the majority of medical studies regarding lactate have examined its use as a biomarker and resuscitation endpoint in patients with sepsis and septic shock.
An elevated lactate is not specific to septic shock. Any process that causes tissue hypoperfusion and subsequent anaerobic metabolism can lead to an elevated lactate.
There are many conditions other than shock that may lead to an elevated lactate: mesenteric ischemia, liver failure, DKA, and certain medications/toxicological causes."
http://www.emdocs.net/utility-obtaining-lactate-measurement-ed/