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2016, Number 3

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Med Crit 2016; 30 (3)

Hyperlactatemia in hyperventilation and respiratory alkalosis: report of three cases and literature review

Manzur SD

Language: Spanish
References: 21
Page: 204-208
PDF size: 150.94 Kb.


ABSTRACT

Hyperventilation is accompanied by respiratory alkalosis and hypocapnia. Hyperventilation is generated when there is any stimulus that generates the start of the ventilatory drive in the respiratory center (hypoxemia), when there is some intrinsic or extrinsic stimulation of the respiratory center which generates increased ventilation improperly (psychogenic mechanism) or the presence of afferent impulses of the lung parenchyma by the presence of underlying lung disease (pulmonary fibrosis). Conditions that generate hyperventilation are an under-recognized cause of hyperlactatemia, which can cause confusion and inadequate diagnostic and therapeutic measures. The mechanisms explaining hyperlactatemia in hyperventilation are probably decreased clearance due to the effects of alkalosis and hypocapnia in various circulatory beds, although this is not well defined. We review three cases of hyperventilation in which it was documented hyperlactatemia which was reversed by removing the stimulus that triggered excessive ventilation. The pathophysiological mechanisms involved in generating respiratory alkalosis and hypocapnia in hyperventilation and the theories proposed to explain the increased serum levels of lactate in this clinical setting are also reviewed.


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