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.”
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Lactate clearance as a target of therapy in sepsis: a flawed paradigm