Belu Alina, Filip Nina, Trandafir Laura Mihaela, Spoială Elena Lia, Țarcă Elena, Zamosteanu Diana, Ghiga Gabriela, Bernic Jana, Jehac Alina, Cojocaru Elena
Department of Morphofunctional Sciences I-Pathology, Faculty of Medicine, "Grigore T. Popa" University of Medicine and Pharmacy, 700115 Iasi, Romania.
Department of Morphofunctional Sciences II-Biochemistry, Faculty of Medicine, "Grigore T. Popa" University of Medicine and Pharmacy, 700115 Iasi, Romania.
Diagnostics (Basel). 2025 Mar 23;15(7):816. doi: 10.3390/diagnostics15070816.
Measurement of circulating lactate is an essential diagnostic tool in pediatric medicine, playing a crucial role in assessing metabolic status and tissue oxygenation. Initially regarded as a byproduct of anaerobic metabolism, recent research has expanded our understanding of lactate's roles across various physiological systems, from energy metabolism to immune modulation and neurological health. Elevated lactate levels are widely utilized to monitor critical conditions such as sepsis, trauma, and hypoxic-ischemic injury, offering valuable prognostic information in intensive care settings. Notably, lactate dynamics-particularly trends in serial measurements-are more effective than single readings for predicting clinical outcomes, especially in sepsis and trauma. Measurement of circulating lactate in different body fluids (blood, cerebrospinal fluid, and umbilical blood) provides critical insights into neonatal health and central nervous system involvement. However, challenges remain, including the need for non-invasive and rapid point-of-care testing, particularly in neonatal populations. Our aim was to review and synthesize the current literature on the role and particularities of measurement of circulating lactate in pediatric pathology. Emerging technologies, such as machine learning models and small molecule inhibitors, show promise in advancing lactate regulation and predicting hemodynamic instability. As the role of lactate in pediatric pathology continues to evolve, optimizing measurement protocols and exploring new therapeutic strategies will enhance early detection, intervention, and clinical outcomes for critically ill children.
循环乳酸的测量是儿科学中的一项重要诊断工具，在评估代谢状态和组织氧合方面发挥着关键作用。乳酸最初被视为无氧代谢的副产物，最近的研究扩展了我们对乳酸在各种生理系统中作用的理解，从能量代谢到免疫调节和神经健康。升高的乳酸水平被广泛用于监测败血症、创伤和缺氧缺血性损伤等危急情况，在重症监护环境中提供有价值的预后信息。值得注意的是，乳酸动态变化——特别是连续测量的趋势——在预测临床结果方面比单次读数更有效，尤其是在败血症和创伤中。在不同体液（血液、脑脊液和脐血）中测量循环乳酸可为新生儿健康和中枢神经系统受累情况提供关键见解。然而，挑战依然存在，包括需要无创和快速的即时检测，尤其是在新生儿群体中。我们的目的是回顾和综合当前关于循环乳酸测量在儿科病理学中的作用和特殊性的文献。机器学习模型和小分子抑制剂等新兴技术在推进乳酸调节和预测血流动力学不稳定方面显示出前景。随着乳酸在儿科病理学中的作用不断演变，优化测量方案并探索新的治疗策略将提高危重症儿童的早期检测、干预和临床结果。
