• Jan Bakker, Radu Postelnicu, and Vikramjit Mukherjee.
• Division of Pulmonary Critical Care, and Sleep Medicine, New York University School of Medicine, Bellevue Hospital, 462 First Avenue | NBV-10W18, New York, NY 10016, USA; Department of Pulmonology and Critical Care, Columbia University Medical Center, New York, NY, USA; Department Intensive Care Adults, Erasmus MC University Medical Center, Rotterdam, Netherlands; Department of Intensive Care, Pontificia Universidad Católica de Chile, Santiago, Chile. Electronic address: Jan.bakker@nyulangone.org.
• Crit Care Clin. 2020 Jan 1; 36 (1): 115-124.

AbstractThere is a tight relationship between lactate levels (and its changes over time) with morbidity and mortality and the presence of tissue hypoxia/hypoperfusion in both models of shock and clinical studies. These findings have placed lactate in the center of guiding resuscitation in patients with increased lactate levels. However, given the complex metabolism and clearance of lactate, especially in sepsis, the actual use of lactate is more complex than suggested by some guidelines. By using other markers of tissue hypoperfusion together with lactate levels provides a more solid framework to guide the initial hours of resuscitation.Copyright © 2019 Elsevier Inc. All rights reserved.

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