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Point of measurement of lactate in emergency medicine

Annales Francaises de Medecine d'Urgence, ISSN: 2108-6524, Vol: 1, Issue: 3, Page: 185-191
2011
  • 2
    Citations
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  • 15
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Metric Options:   Counts1 Year3 Year

Metrics Details

  • Citations
    2
    • Citation Indexes
      1
    • Policy Citations
      1
      • Policy Citation
        1
  • Captures
    15

Article Description

Lactate is an end product of glycolysis that may accumulate in case of excess production of lactate or failure of its metabolic clearance. Normal plasma concentration of lactate is less than 2 mmol/l and its normal half-life is short, less than 10 mins. There is a rise in plasma lactate during clinical situations associated with tissue hypoxia, which may be absolute (shock state, deep hypoxemia, ischemia, etc.) or relative (strenuous exercise, seizures, malignant hyperthermia), but also under conditions without obvious tissue hypoxia (sepsis, metabolic abnormalities, terminal hepatic failure). Lactic acidosis is defined as a metabolic acidosis explained by a blood lactate concentration greater than 5 mmol/l. The presence of hyperlactatemia is an indicator of severity in many diseases and should prompt the physician to provide immediate care for the patient. Thus, routine measurement of blood lactate during the screening stage of some diseases such as sepsis or severe trauma allows early detection of patients requiring a rapid and specific response. Moreover, repeated measurement of blood lactate make a real biological monitoring of the effectiveness of initial treatment of acute circulatory failure. Some pointof- care reliable lactate measurement can be made in the emergency department using microsamples of whole blood makes this measure more feasible during triage or lifethreatening situations. At last, the measurement of lactate levels in CSF during acute meningitis is probably one of the best indicators to distinguish early bacterial infections from viral meningitis. © 2011 Société française de médecine d'urgence and Springer-Verlag France.

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