The following lines show the abstract of the article called “Lactate clearance as a target of therapy in sepsis: a flawed paradigm”, which was written in English by PE Marik and R Bellomo, and published in OA Critical Care 2013 Mar 01;1(1):3.

“Introduction: An increased blood lactate level is widely believed to be a marker of inadequate oxygen delivery and an­aerobic metabolism. Furthermore, the rate of decline in lactate concen­tration (lactate clearance) has been recommended as an end-point of early goal directed therapy in critical ill patients with sepsis. We provide compelling data that an elevated lac­tate concentration is a consequence of increased aerobic glycolysis as part of the stress response and that titrat­ing therapy to the rate of decline in lactate concentration is a potentially harmful endeavour. Furthermore, an increased lactate concentration may be an important adaptive survival re­sponse during critical illness.

Conclusion: An elevated lactate concentration in patients with sepsis is a marker of dis­ease severity and not an indication of anaerobic metabolism. Increasing ox­ygen delivery to treat a non-existent oxygen debt may be a harmful under­taking. ‘Lactate clearance’ should not be used as the end-point of resuscita­tion in patients with sepsis.”

Please click here to download the original article:
Lactate clearance as a target of therapy in sepsis: a flawed paradigm