Measurement of blood lactate levels and excess lactate as indices of hypoxia during anaesthesia

Chamberlain, Jocelyn; Lis, Mark

doi:10.1111/j.1365-2044.1968.tb00115.x

Cited by 4 publications

(2 citation statements)

References 26 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Limitations of the current study should be acknowledged. The study population was heterogeneous (with medical and surgical patients) and the patients were classified using criteria applied in brain injury (although the L/P ratio and pyruvate are considered to be essentially constant in all tissues [28,37]). In the brain MD studies [21,22,23,24] the catheters were placed directly in the affected tissue (namely cerebral tissue), while in our study the MD catheters were placed in adipose tissue (with the aim of studying adipose tissue metabolism).…”

Section: Discussionmentioning

confidence: 99%

Microdialysis-Assessed Adipose Tissue Metabolism, Circulating Cytokines and Outcome in Critical Illness

et al. 2018

View full text Add to dashboard Cite

Microdialysis (MD) can provide continuous information about tissue composition. To assess in critically ill patients adipose tissue metabolic patterns, the relationships between metabolic patterns and blood cytokine concentration associations of adipose tissue energy metabolism and clinical outcome we studied 203 mechanically ventilated general intensive care unit (ICU) patients. Upon ICU admission an MD catheter was inserted into the subcutaneous adipose tissue of the upper thigh to measure lactate (L), glucose, pyruvate (P), and glycerol. Serum concentrations of IL-10, IL-6, IL-8, and TNF-α were determined within 48 h from ICU admission. Mitochondrial dysfunction was defined as L/P ratio >30 and pyruvate ≥70 μmol/L, ischemia as L/P ratio >30 and pyruvate <70 μmol/L and no ischemia/no mitochondrial dysfunction (i.e., aerobic metabolism) was as L/P ratio ≤30. Metabolism was aerobic in 74% of patients. In 13% of patients there was biochemical evidence of ischemia and in 13% of patients of mitochondrial dysfunction. Mitochondrial dysfunction was associated with poor outcome. In conclusion, MD showed that about two thirds of critically ill patients have normal aerobic adipose tissue metabolism. Mitochondrial dysfunction was not common but was associated with poor outcome. Identifying subgroups of critically ill patients is crucial as different treatment strategies may improve survival.

show abstract

Section: Discussionmentioning

confidence: 99%

Microdialysis-Assessed Adipose Tissue Metabolism, Circulating Cytokines and Outcome in Critical Illness

et al. 2018

View full text Add to dashboard Cite

show abstract

“…However, therapies that have been aimed directly at lowering serum lactate have failed to produce a significant impact on this mortality rate [123]. Lactate has been cited as a marker of tissue hypoxia for over 30 years [124]. This is now being questioned because it is recognised that there are multiple mechanisms through which it may increase in the critically ill [125±127].…”

Section: Significance Of Lactic Acidosismentioning

confidence: 99%

Anions and the anaesthetist

2002

View full text Add to dashboard Cite

SummaryAnions are the negative components of most chemical structures and play many important physiological and pharmacological roles that are of interest to the anaesthetist. Their relevance is reviewed with a particular emphasis on the inorganic anions (halides, bicarbonate, phosphate and sulphate) and the significance and limitations of the anion gap. Organic anions (albumin, lactate) are also discussed, albeit briefly. The suitability of anions for their role in neurotransmission and acid2base balance is outlined.

show abstract