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sábado, 2 de febrero de 2019

Lactate is Not Everything

emDocs - January 28, 2019 - Authors: Camacho-Ruiz C and Silverberg M
Edited by: Koyfman A and Long B
"Take Home Points
  • The exact pathophysiology of an elevated lactate is likely multifactorial, patient-specific, and disease-specific.
  • The patient can be extremely sick but not yet in multi-organ failure. Their kidneys and liver can be working to their maximum potential to clear the lactate but this will probably eventually fail. Be ready.
  • Clinical judgment is not a number, and sepsis is not equal to elevated lactate. Our goal should be to treat the primary disease instead of a number which is a marker of multiple metabolic reactions, not only oxidative stress secondary to hypoxia.
  • Beta blockers can decrease lactate production in septic patients. Beware."