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Critical Care
Published in: Critical Care 6/2005

01-12-2005 | Review

Lactate as a marker of energy failure in critically ill patients: hypothesis

Authors: Franco Valenza, Gabriele Aletti, Tommaso Fossali, Giorgio Chevallard, Francesca Sacconi, Manuela Irace, Luciano Gattinoni

Published in: Critical Care | Issue 6/2005

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Abstract

Lactate measurement in the critically ill has been traditionally used to stratify patients with poor outcome. However, plasma lactate levels are the result of a finely tuned interplay of factors that affect the balance between its production and its clearance. When the oxygen supply does not match its consumption, organisms such as man who are forced to produce ATP for their integrity adapt in many different ways up to the point when energy failure occurs. Lactate, being part of the adaptive response, may then be used to assess the severity of the supply/demand imbalance. In such a scenario, the time to intervention becomes relevant: early and effective treatment may allow the cell to revert to a normal state, as long as the oxygen machinery (i.e. mithocondria) is intact. Conversely, once the mithocondria are deranged, energy failure occurs even in the presence of normoxia. The lactate increase in critically ill patients may therefore be viewed as an early marker of a potentially reversible state.
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Metadata
Title
Lactate as a marker of energy failure in critically ill patients: hypothesis
Authors
Franco Valenza
Gabriele Aletti
Tommaso Fossali
Giorgio Chevallard
Francesca Sacconi
Manuela Irace
Luciano Gattinoni
Publication date
01-12-2005
Publisher
BioMed Central
Published in
Critical Care / Issue 6/2005
Electronic ISSN: 1364-8535
DOI
https://doi.org/10.1186/cc3818

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