Clinica chimica acta; international journal of clinical chemistry
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In response to clinical demand some point-of-care analysers now provide blood lactate measurements, but recently concern has been expressed about the value and interpretation of these measurements. We undertook this study to evaluate blood lactate measurements in patients with acute renal failure undergoing haemofiltration (HF) with lactate replacement fluid. At baseline, 27 patients had base deficits of >5 mmol/l and 14 (52%) had blood lactates of >3.5 mmol/l. ⋯ Of the remaining 12 patients with improved base deficit (+2 to +20), 10 (83%) survived. Lactate tolerance was compromised in patients with co-incidental liver disease, those on inotropic support, and in patients with initial blood lactate measurements of >10 mmol/l and large base deficits. The data suggest that blood lactate and simultaneous acid-base response measurements during HF help to assign correct buffer replacement and should be performed on all patients.