A REVIEW OF THE ROLE OF BLOOD LACTATE MEASUREMENTS IN THE ICU

The production of hyperlactatemia in the critically ill patient has pr eviously been thought to be primarily related to anaerobic conditions. Newer data suggests that lactate accumulates under aerobic conditions in clinical settings that were previously thought to solely represent anaerobic processes. This review summarizes the present understanding of lactate metabolism;ind reviews the data supporting use of lactate determinations in the critical care setting. The use of lactate as a m arker of inadequate tissue perfusion as well as its role as a prognost ic indicator are discussed. The utility of managing lactic acidosis wi th various buffers is also reviewed.