Deulkar Pallavi, Singam Amol, Mudiganti V N K Srinivas, Jain Abhishek
Critical Care Medicine, Jawaharlal Nehru Medical College, Datta Meghe Institute Of Higher Education and Research, Wardha, IND.
Cureus. 2024 Aug 7;16(8):e66356. doi: 10.7759/cureus.66356. eCollection 2024 Aug.
Lactate monitoring is critical in managing critically ill patients in intensive care settings. Elevated lactate levels often signify underlying metabolic disturbances such as tissue hypoxia, anaerobic metabolism, or impaired lactate clearance, which are prevalent in conditions like sepsis, shock, and trauma. Understanding the physiological basis of lactate production and its significance in clinical practice is essential for interpreting its diagnostic and prognostic value. This comprehensive review aims to explore the utility of lactate monitoring across various critical care scenarios. It provides an overview of lactate's metabolic pathways, methods of measurement, and the clinical implications of interpreting lactate levels in different contexts. Additionally, the review discusses current evidence on lactate-guided therapeutic interventions and highlights challenges and limitations to their application. By synthesizing the existing literature and clinical insights, this review aims to enhance the understanding of the role of lactate monitoring in assessing disease severity, guiding treatment strategies, and predicting outcomes in critically ill patients. Ultimately, this review underscores the importance of integrating lactate monitoring into routine clinical practice to optimize patient care and improve clinical outcomes in intensive care settings.
在重症监护环境中管理重症患者时,乳酸监测至关重要。乳酸水平升高通常表明存在潜在的代谢紊乱,如组织缺氧、无氧代谢或乳酸清除受损,这些情况在脓毒症、休克和创伤等病症中很常见。了解乳酸产生的生理基础及其在临床实践中的意义对于解读其诊断和预后价值至关重要。这篇全面综述旨在探讨乳酸监测在各种重症监护场景中的效用。它概述了乳酸的代谢途径、测量方法以及在不同情况下解读乳酸水平的临床意义。此外,该综述讨论了关于乳酸引导的治疗干预措施的现有证据,并强调了其应用中的挑战和局限性。通过综合现有文献和临床见解,本综述旨在增进对乳酸监测在评估疾病严重程度、指导治疗策略以及预测重症患者预后方面作用的理解。最终,本综述强调了将乳酸监测纳入常规临床实践以优化重症监护环境中的患者护理并改善临床结果的重要性。