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Colegio de Medicina Interna de México.

2019, Number 6

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Med Int Mex 2019; 35 (6)

Lactato: marker of hypoperfusion?

Duarte-Mote J, Lee-Eng CV, Romero-Figueroa S, Aguilar-Hidalgo JA, Gómez-Hernández GL, Sánchez-Rojas G

Language: Spanish
References: 56
Page: 934-943
PDF size: 344.78 Kb.


ABSTRACT

Lactate is an intermediate product in the metabolism of carbohydrates and the nonessential metabolism of amino acids. The complexity of metabolic and intercellular interactions makes it possible to consider lactate a metabolic reserve product rather than a waste product. For decades high levels of blood lactate have been considered a factor of poor prognosis. Currently the therapy aimed at decreasing lactate seems very promising. The decrease in lactate levels as a therapeutic goal has shown a decrease in mortality rates in patients with septic shock. However, this behavior is not constant in the different studies that have been carried out in this regard. Recent reflections arising from studies carried out at the end of the previous century and at the beginning of this question the association of lactate with tissue hypoperfusion. There are even jobs in which there is evidence of greater survival in those patients where the lactate level was increased. There is biochemical evidence that justifies the idea of lactate as an energy source in a state of stress and its possible function as a marker of endocrinological reserve. Finally, it is possible that the kinetics of lactate production can be interpreted in two different ways. The first one, as a marker of endocrine reserve and that is carried out in the first hours after initiation of the state of septic shock and the second phase after the previous one and that can be explained indirectly by tissue hypoperfusion.


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