2020
DOI: 10.1155/2020/2608318
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Quantitative Assessment of Blood Lactate in Shock: Measure of Hypoxia or Beneficial Energy Source

Abstract: Blood lactate concentration predicts mortality in critically ill patients and is clinically used in the diagnosis, grading of severity, and monitoring response to therapy of septic shock. This paper summarizes available quantitative data to provide the first comprehensive description and critique of the accepted concepts of the physiology of lactate in health and shock, with particular emphasis on the controversy of whether lactate release is simply a manifestation of tissue hypoxia versus a purposeful transfe… Show more

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Cited by 17 publications
(22 citation statements)
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References 173 publications
(200 reference statements)
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“…Despite the reduced fluid requirements, lactate levels partially normalized with vehicle and INCB3284 treatment, and creatinine concentrations were indistinguishable between the groups. This suggests that the fluid-sparing effects of INCB3284 do not occur at the expense of tissue hypoperfusion, altered metabolism, or impairment of kidney function ( 37 ).…”
Section: Discussionmentioning
confidence: 99%
“…Despite the reduced fluid requirements, lactate levels partially normalized with vehicle and INCB3284 treatment, and creatinine concentrations were indistinguishable between the groups. This suggests that the fluid-sparing effects of INCB3284 do not occur at the expense of tissue hypoperfusion, altered metabolism, or impairment of kidney function ( 37 ).…”
Section: Discussionmentioning
confidence: 99%
“…On the other hand, there is also the possibility that the non-accumulation of lactate in the bloodstream may be due to its consumption by the liver and kidneys, through the Cori cycle, allowing the production of more glucose. The increase in LDH could reinforce this idea, since this enzyme is also involved in the conversion of lactate to pyruvate in the Cori cycle (Marik and Bellomo, 2013;Gurung and Jialal, 2020;Levitt et al, 2020;Yang et al, 2020).…”
Section: Will There Be Lactic Acidosis In Sars-cov-2 Infection Due To Alteration Of the Glycolytic Pathway?mentioning
confidence: 93%
“…Lactate and succinate accumulation built up a metabolic and oxygen debt reimbursed later by mitochondrial oxidative metabolism when oxygen becomes available. This time-based relationship finds an echo in spatial organization and muscles/erythrocytes and liver (in the long range) [22,26], glial cells and neurons [27,28] or stromal and cancer cells [29] (in the short range) constitutes examples of spatially organized metabolic synergy between lactate producers and lactate consumers. Similar spatial organization with succinate appears to emerge in the retina [30].…”
Section: Time and Spacementioning
confidence: 99%
“…Both cancer and innate immune response (inflammation) are associated to anaerobic energy production [21]. In addition, heterogeneity of tissue O 2 concentration (Krogh model) is supposed to generate some lactate releasing domains and this even in absence of inflammation or cancer, this is reviewed in [22]. Finally, it should be noted that the formulation of Warburg effect as "lactate release although oxygen is sufficient" means actually "although oxygen is sufficient to ensure a better yield in ATP per glucose used".…”
Section: The Oxygen Issuementioning
confidence: 99%