Too much lactate or too little liver?

Hydroxyethyl Starch 6% (130/0.4) Ameliorates Acute Lung Injury in Swine Hemorrhagic Shock

“…A growing body of literature supports inflammation as the cause of increased lactate in several clinical situations (e.g., sepsis, burns, trauma). 27 One likely explanation concerning the lower lactate levels measured after 6% HES 130/ 0.4 infusion may be the lower whole blood viscosity after administration of the particular solution compared with older starch preparations. 28 Our study has several limitations: first our model of controlled hemorrhage does not take into account the associated traumatic injuries.…”

Lactate and liver function tests after living donor right hepatectomy: a comparison of solutions with and without lactate

“…We also investigated the effects of lactate‐containing crystalloid solution on post‐operative lactate and liver profiles. In patients who undergo hepatectomy for hepatocellular carcinoma, the intraoperative use of LR solution may contribute to elevated lactate concentrations by increasing the amount of total lactate to be metabolized 12,13 . Therefore, to minimize lactate load in situations of potential hepatic dysfunction, lactate‐containing solution is usually not recommended during donor hepatectomy 4 .…”

Blood lactate and pyruvate levels in the perioperative period of liver resection with pringle maneuver

“…Thus, clinically the phenomenon of lactic acidosis is created, with consecutive damage to liver cells and a decrease in protein synthesis. Pre-existing limitations of liver-function like hepatitis and cirrhosis may additionally contribute to a further increase in lactate [20,21].…”

“…The stress which the liver has to endure during the resection leads to both systemic and local release of pro-inflammatory cytokines (TNF, IL-1) from leucocytes. These cytokines stimulate the lactate production of inflammatory cells such as Kupffer cells [18,21]. Vollmar [35] and Waisman [36] investigated, in cases of occlusion of the portal vein with subsequent congestion in the splanchnic-nerve area, a further cause for the damage to liver cells.…”

“…Due to this fact, its rapid continued transformation in carbohydrate metabolism, and the very short half-time, only limited conclusions can be drawn with respect to the effect of vascular occlusion upon the metabolic capacity of the liver. Hypoxic conditions, which are related to anesthesia and surgical interventions without involvement of the liver, may also contribute to an impaired draining of pyruvate into the respiratory chain or a decrease in oxygen-dependent gluconeogenesis [21]. There is a short accumulation and, depending on the synthesis capacity of the lactate dehydrogenasis (LDH), there is further conversion to lactate.…”