Lactate and lactate clearance in acute cardiac care patients

Abstract

Hyperlactataemia is commonly used as a diagnostic and prognostic tool in intensive care settings. Recent studies documented that serial lactate measurements over time (or lactate clearance), may be clinically more reliable than lactate absolute value for risk stratification in different pathological conditions. While the negative prognostic role of hyperlactataemia in several critical ill diseases (such as sepsis and trauma) is well established, data in patients with acute cardiac conditions (i.e. acute coronary syndromes) are scarce and controversial. The present paper provides an overview of the current available evidence on the clinical role of lactic acid levels and lactate clearance in acute cardiac settings (acute coronary syndromes, cardiogenic shock, cardiac surgery), focusing on its prognostic role.

Keywords: Acute cardiac setting; lactate; lactate clearance.

Conflict of interest statement

Conflict of interest: None.

Figures

Figure 1.

The Cori cycle.

Figure 2.

Flow-chart of lactate in acute cardiac settings.