Department of Intensive Care, Erasme Hospital, Université libre de Bruxelles, Brussels, Belgium.
Department of Intensive Care, Erasmus MC - University Medical Center, Rotterdam, The Netherlands.
Curr Opin Crit Care. 2021 Jun 1;27(3):298-302. doi: 10.1097/MCC.0000000000000824.
Blood lactate concentrations are frequently measured in critically ill patients and have important prognostic value. Here, we review some key questions related to their clinical use in sepsis.
Despite the metabolic hurdles, measuring lactate concentrations remains very informative in clinical practice. Although blood lactate levels change too slowly to represent the only guide to resuscitation, serial lactate levels can help to define the patient's trajectory and encourage a review of the therapeutic strategy if they remain stable or increase over time.
Lactate concentrations respond too slowly to be used to guide acute changes in therapy, but can help evaluate overall response. Hyperlactatemia should not be considered as a problem in itself, but as a warning of altered cell function.
在危重病患者中经常检测血乳酸浓度，其具有重要的预后价值。本文就脓毒症相关的一些临床应用的关键问题进行综述。
尽管存在代谢障碍，乳酸浓度的测量在临床实践中仍然非常有意义。尽管血乳酸水平的变化太慢，不能作为复苏的唯一指导，但连续的乳酸水平可以帮助确定患者的轨迹，并在其保持稳定或随时间增加时鼓励重新评估治疗策略。
乳酸浓度的变化太慢，不能用于指导急性治疗变化，但可以帮助评估整体反应。高乳酸血症不应被视为自身的问题，而应视为细胞功能改变的警告。
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