Blood lactate concentration is one of the most often measured parameters during clinical exercise testing as well as during performance testing of athletes. While an elevated blood lactate concentration may be indicative of ischemia or hypoxemia, it may also be a “normal” physiological response to exertion.
Elevated blood lactate concentration ([La- ]b) levels can be used to evaluate an underlying pathology during a routine stress test (coronary artery disease, chronic airway obstruction, chronic renal failure, metabolic impairment) and as it can also be used to prescribe appropriate exercise intensities for different patient populations, it has been recommended that ([La- ]b) analysis are added to normal stress testing measurements.
In response to “all-out” maximal exertion lasting 30‑120 seconds, peak ([La- ]b) values of ≈15–25 mM may be observed 3–8 minutes postexercise. In response to progressive, incremental exercise, ([La- ]b) increases gradually at first and then more rapidly as the exercise becomes more intense. The work rate beyond which the ([La- ]b) increases exponentially (the lactate threshold, LT), is a better predictor of performance than VO2max and is a better indicator of exercise intensity than heart rate; thus the LT (and other valid methods of describing this curvilinear ([La- ]b) response with a single point) is useful in prescribing exercise intensities for most diseased and nondiseased patients alike.
Overall, it is worthwhile for clinicians to have a thorough understanding of ([La- ]b) responses, blood lactate transport and distribution, and ([La- ]b) analysis.
This article, titled “Blood Lactate Measurements and Analysis during Exercise: A Guide for Clinicians”, was written by Matthew L. Goodwin, M.A., James E. Harris, M.Ed.,Andrés Hernández, M.A., and L. Bruce Gladden, Ph.D., and published on Journal of Diabetes Science and Technology, Volume 1, Issue 4, July 2007
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Blood Lactate Measurements and Analysis during Exercise: A Guide for Clinicians