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Lactate measurements in sepsis-induced tissue hypoperfusion: results from the Surviving Sepsis Campaign database. 2014;371(24):2309–19.Vernon C, Letourneau JL.
Metabolic acidosis or respiratory alkalosis? Are arterial and venous samples clinically equivalent for the estimation of pH, serum bicarbonate and potassium concentration in critically ill patients? Severe hyperlactatemia with normal base excess: a quantitative analysis using conventional and Stewart approaches. In addition, new data on diagnosis and prognostic tools and the treatment of metabolic acidosis have enriched literature.
2013;39(4):299–305.Fisher JN, Shahshahani MN, Kitabchi AE. Am J Emerg Med. Time course for development of respiratory compensation in metabolic acidosis. The NKF/KDOQI guidelines recommend starting treatment when serum bicarbonate levels are <22 mEq/L, in order to maintain levels ≥ 22 mEq/L.Veverimer (TRC 101) is a promising investigational drug designed to treat metabolic acidosis by binding with the acid in the gastrointestinal tract and removing it from the body through excretion in the feces, in turn decreasing the amount of acid in the body, and increasing the level of bicarbonate in the blood. When considering course of treatment, it is important to distinguish between acute versus chronic forms. It is of low level of evidence, as the parameter used (urinary anion gap) is also a diagnostic criterion of the expected clinical picture (tubular acidosis) [R1.7—The experts suggest that measurement of urinary pH should be restricted to patients with metabolic acidosis without unmeasured anions or obvious etiology, and with a strong clinical suspicion of tubular acidosis (EXPERT OPINION).R1.8—The experts suggest that a normal value of venous lactate discounts hyperlactatemia (EXPERT OPINION).R1.9—Arterial lactate should probably be measured to confirm hyperlactatemia in case of increased venous lactate (GRADE 2+, STRONG AGREEMENT).Measurement of venous lactate has also been assessed in prognostic cohort studies of patients with severe trauma, suspected septic shock, or admitted to the emergency room [In conclusion, whereas the measurement of venous lactate can be useful in determining the prognosis, the literature data do not support its use in the diagnosis of hyperlactatemia.R1.10—Capillary blood lactate should not be measured to diagnose hyperlactatemia (GRADE 1−, STRONG AGREEMENT).Measurement of capillary blood lactate has been proposed as a prognostic tool. J Trauma Acute Care Surg. Eur Respir J. 2004;32(5):1120–4.Fine MJ, Auble TE, Yealy DM, Hanusa BH, Weissfeld LA, Singer DE, et al. The aim was not necessary to reach a single and convergent opinion of the experts on all the proposals, but to define the points of agreement and the points of disagreement or uncertainty. J Trauma Acute Care Surg. Singapore Med J.
J Trauma Acute Care Surg. * cAG = AG + (40 − [albuminemia]) × 0.25, with albuminemia in g/L.R1.4—The experts suggest first applying the Henderson–Hasselbalch method using the anion gap corrected for albumin for the diagnosis of the mechanism of metabolic acidosis. 2018;392(10141):31–40.Weng Y-M, Wu S-H, Li W-C, Kuo C-W, Chen S-Y, Chen J-C. Diabetic ketoacidosis: effective low-cost treatment in a community hospital. 2013;31(9):1365–7.Tanner RK, Fuller KL, Ross MLR. 2015;43(8):1716–30.Hovda KE, Hunderi OH, Tafjord A-B, Dunlop O, Rudberg N, Jacobsen D. Methanol outbreak in Norway 2002–2004: epidemiology, clinical features and prognostic signs. 1978;62(5):873–6.Juurlink DN, Gosselin S, Kielstein JT, Ghannoum M, Lavergne V, Nolin TD, et al.
2006;24(2):156–61.Monsieurs KG, Nolan JP, Bossaert LL, Greif R, Maconochie IK, Nikolaou NI, et al. Initial blood pH during cardiopulmonary resuscitation in out-of-hospital cardiac arrest patients: a multicenter observational registry-based study.
Acid-base disorders are a group of conditions characterized by changes in the concentration of hydrogen ions (H +) or bicarbonate (HCO 3-), which lead to changes in the arterial blood pH.These conditions can be categorized as acidoses or alkaloses and have a respiratory or metabolic origin, depending on the cause of the imbalance. Effect of sodium bicarbonate administration on mortality in patients with lactic acidosis: a retrospective analysis.
2010;38(4):422–7.Page MM, Alberti KG, Greenwood R, Gumaa KA, Hockaday TD, Lowy C, et al. By using this website, you agree to our DV, AL, EM, MD, MM, and JL contributed to elaborate recommendations and wrote the rationale of « Diagnostic strategy ». Serum lactate as a predictor of mortality in emergency department patients with infection.
Crit Care Med. 2013;47(7–8):970–5.Viallon A, Zeni F, Lafond P, Venet C, Tardy B, Page Y, et al.
2018;378(3):270–80.Noritomi DT, Soriano FG, Kellum JA, Cappi SB, Biselli PJC, Libório AB, et al.
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