Lactate and lactate clearance in acute cardiac care patients

El lactato y su aclaramiento en pacientes de atención cardiaca aguda

Today we bring you a recap of this article, written by Paola Attanà, Chiara Lazzeri, Claudio Picariello, Carlotta Sorini Dini, Gian Franco Gensini and Serafina Valente and published in 2012 by European Heart Journal: Acute Cardiovascular Care

 

With this article, Attanà et al aim to summarize the evidence available on the clinical role of lactate levels and lactate clearance in acute cardiac settings (acute coronary syndromes, cardiogenic shock and cardiac surgery), with a focus on its prognostic role.

The authors, based on the evidence available and their own experience, indicate that absolute serum lactate values provide helpful insight in the haemodynamic status of the single patient, especially regarding systemic perfusion. This allows for early risk stratification and the possibility of adjusting monitoring and therapy.

According to the authors who base the information on their policy and clinical experiences, lactate guided therapy has the following therapeutic targets:

  • optimizing mean arterial pressure (i.e. tissue perfusion) by means of fluid therapy/inotrope administration
  • multi-organ protection (by means of early implementation of renal replacement therapy/early enteral nutrition);
  • optimizing metabolic control (by means of insulin infusion therapy);
  • prevention/treatment of infections.

Please click here to access the original article:
Lactate and lactate clearance in acute cardiac care patients