Fencl V, Leith DE. Pernet P, Bénéteau-Burnat B, Vaubourdolle M, Maury E, Offenstadt G. False elevation of blood lactate reveals ethylene glycol poisoning. Ultraviolet/visible (UV/VIS) absorption spectroscopy has been used for clinical analysis for many years. Biting into a chili pepper causes a burning spiciness that is irresistible to some, but intolerable to others. Murray et al.

Gladden LB. Brinkman K. Editorial response: hyperlactatemia and hepatic steatosis as features of mitochondrial toxicity of nucleoside analogue reverse transcriptase inhibitors. Blood lactate levels are superior to oxygen-derived variables in predicting outcome in human septic shock. Table 1 gives some of the common causes under each category. Karon BS, Scott R, Burritt MF, Santrach PJ. Stewart and beyond: new models of acid-base balance. LaManna JC, Harrington JF, Vendel LM, Abi-Saleh K, Lust WD, Harik SI. Medicine 1998;77:73–82. Finally, D-lactic acidosis, due to an elevation of D-lactate- the stereoisomer of the more commonly measured L-lactate, is a more recently described finding in patients with short bowel syndrome and also patients with DKA. Click here to sign in with Ann N Y Acad Sci 1965;119:920–6. Lactic acidosis. Volume 55, Issue 3, Pages 322–333, eISSN 1437-4331, ISSN 1434-6621, Causes and classification of lactic acidosis, Lactate measurement in ethylene glycol poisoning, Classical and Ancient Near Eastern Studies, Library and Information Science, Book Studies, http://www.aacc.org/AACC/members/nacb/LMPG/OnlineGuide/DraftGuidelines/EB_for_POCT2004, – Gastric necrosis and other causes of splanchnic ischaemia, – β-Agonists, including cocaine and epinephrine, B3: Associated with inborn errors of metabolism. Precise measurements are critical to the discovery, development and usage of medications. However, LDH is isomer-specific, meaning that L-lactate is produced by L-LDH and D-lactate by D-LDH [84], [85]. The Nova analyser reported higher lactate results than either the Vitros or Integra. J Intensive Care Med 2005;20:255–71. Am Fam Physician 2013;88:634–6. Lactate uptake by skeletal muscle.

Due to the large capacity of the liver to metabolise lactate, elevated lactic acid levels due to increased production usually return to normal after 1–2 h. If lactic acidosis occurs for longer than this, it signals either continuing production or a decreased ability of the liver to metabolise it.
Researchers at the Indian Institute of Science (IISc) have developed a method to rapidly identify and check whether a disease-causing bacterium is alive or dead. Martí R, Varela E, Segura RM, Alegre J, Suriñach JM, Pascual C. Determination of D-lactate by enzymatic methods in biological fluids: study of interferences. Pediatrics 2015;135: e221–4. Shock 2008;30:417–21. Relationship between serum glycolate and falsely elevated lactate in severe ethylene glycol poisoning. found that targeting a decrease of at least 20% in the blood lactate level over a 2-h period seemed to be associated with reduced in-hospital mortality [61]. Whole blood applications include the i-STAT (Abbott Laboratories), Radiometer ABL 725 blood gas analyser (Radiometer Medical A/S), and the Lactate Plus (Nova Biomedical) [64].
Over the last decade, there have been key studies performed to compare the performance of these POC methods versus traditional methods. Corey HE. There has been a drive toward POC methods for measurement of whole blood lactate to reduce the turnaround time. Robergs RA, Ghiasvand F, Parker D. The wandering argument favoring a lactic acidosis. Noordally O, Vincent JL.

Occurrence and adverse effect on outcome of hyperlactatemia in the critically ill. Crit Care (London, England) 2009;13:R90. The authors concluded that the sepsis-associated hyperlactataemia may not be due to tissue hypoxia but rather a sequelae to the markedly increased rate of pyruvate production. Rank. The metabolism of D-alpha-hydroxy acids in animal tissues. J Physiol 2009;587(Pt 23):5591–600. The basis for this was the fact that LDH has the highest Vmax of any enzyme in the glycolytic pathway and the equilibrium for the pyruvate to lactate reaction is in favor of lactate production. It is clear that lactate-directed early resuscitation of patients in the ED and ICU has clinical benefit. It appears that increased D-lactate concentrations are associated with the severity of metabolic acidosis and high AG in patients with DKA. It poses a significant danger to children and animals that are more likely to ingest it due to a characteristic sweet taste. Ann Intensive Care 2013;3:12. L-lactate is by far the more abundant form in humans and mammals, existing at concentrations 100 times greater than D-lactate in blood. The possible mechanisms of contracting and paying the oxygen debt and the role of lactic acid in muscular contraction. Corresponding author: Jansen Seheult, MB, MSc, Department of Clinical Chemistry, Adelaide and Meath Hospital, Tallaght, Dublin 24, Ireland, Phone: +14129805667. LiveRank. Clin Chim Acta. A systematic review of published trials stated that blood lactate measurement, especially the trend, is useful for risk assessment in patients acutely admitted to hospital and that all patients with a lactate at admission above 2.5 mmol/L should be closely monitored for signs of deterioration [32]. D-lactic acidosis: turning sugar into acids in the gastrointestinal tract.

Clinical chemistry News and Updates from The Economictimes.com.

Ann N Y Acad Sci 1965;119:1061–9. The interacting variables include equilibria among bicarbonate ion formation, carbonate ion formation, water dissociation and weak acid dissociation, in addition to electrical charge balance and conservation of mass [31]. Jansen TC, van Bommel J, Mulder PG, Rommes JH, Schieveld SJM, Bakker J. N Engl J Med 2014;371:2309–19. There were no differences in treatment in the first 72 h. The study found that lactate directed therapy was not inferior to therapy guided by central venous oxygen saturations. J Infect Dis 1986;154:658–64. Lactate is one of the most crucial intermediates in carbohydrate and nonessential amino acid metabolism. Date. This article discusses the range of application types for which absorption spectroscopy can be used and provides some examples of common analyses. Early lactate-guided therapy in intensive care unit patients: a multicenter, open-label, randomized controlled trial. 6 hours 12 hours 1 day 3 days all. Citation: Clinical Chemistry and Laboratory Medicine (CCLM) 55, 3; 10.1515/cclm-2016-0438 RBCs and plasma provide the key link in the cell-to-cell lactate shuttle. Sepsis is associated with macrocirculatory dysfunction causing arterial hypotension, microcirculatory dysfunction and decreased oxygen and nutrient extraction by tissues [53]. Expert opinion recommends the use of lactate levels, central venous oxygen saturations and cardiac output to guide therapy. The presence of elevated lactate levels in critically ill patients has important implications for morbidity and mortality. The Henderson-Hasselbach equation related plasma [H+] to the partial pressure of carbon dioxide, PCO2 and bicarbonate ion concentration, [HCO3–] [27]. Manini AF, Hoffman RS, McMartin KE, Nelson LS. Swietach P, Vaughan-Jones RD, Harris AL, Hulikova A.

Metformin-associated lactic acidosis: Current perspectives on causes and risk. J Clin Anesth 2014;26:616–22. Most laboratory methods utilise the reaction catalysed by LDH, which is coupled to NAD+ reduction/ NADH oxidation [70]. Philos Trans R Soc Lond B Biol Sci 2014;369:20130099. The two major approaches to acid-base balance in human blood at the time were the Henderson-Hasselbach equation (1918) and the base excess approach [26]. Kruse O, Grunnet N, Barfod C. Blood lactate as a predictor for in-hospital mortality in patients admitted acutely to hospital: a systematic review. Takayesu JK, Bazari H, Linshaw M. Case records of the Massachusetts General Hospital. J Med 2003;23:289–93. Elevated lactate levels may have lead to increased vigilance amongst clinicians with a lower threshold for initiating additional therapies. The latest POC lactate analysers include modern cartridge-based blood gas analysers like the Radiometer ABL800 FLEX series, the Radiometer ABL90 FLEX, the Instrumentation Laboratory GEM Premier 4000 and the Nova Biomedical Stat Profile pHOx Plus L. The Nova Biomedical StatStrip Lactate and the Abbott iSTAT are the latest handheld devices. Lactate is one of the most crucial intermediates in carbohydrate and nonessential amino acid metabolism. Demir IE, Ceyhan GO, Friess H. Beyond lactate: is there a role for serum lactate measurement in diagnosing acute mesenteric ischemia? Hence, lactate metabolism is a much more dynamic process than originally thought. Nifty 11,247.10 68.7. showed that oxygen consumption and the rates of glucose and pyruvate production and oxidation were greater in septic patients compared to healthy volunteers [56]. A recent study done by Lu et al. Ethylene glycol poisoning: quintessential clinical toxicology; analytical conundrum. Am J Physiol 1986;250(6 Pt 1):E634–40. Metformin inhibits complex 1 of the mitochondrial respiratory chain and also suppresses hepatic gluconeogenesis, resulting in both accelerated lactate production and reduced lactate metabolism [41], [42]. Metabolism 1985;34:621–5. (A) Under steady-state conditions, glucose is converted to pyruvate, which is then fully oxidised in the mitochondria to CO2, with the generation of 38 ATP molecules overall.

Lactate metabolism: a new paradigm for the third millennium. From blank round to a potently active substance? Fast, low-cost device uses the cloud to speed up diagnostic testing for HIV, more, Researchers identify lipid profile characteristic of newly diagnosed type 1 diabetes, New technique paves way for medical discoveries, Science X Daily and the Weekly Email Newsletter are free features that allow you to receive your favorite sci-tech news updates in your email inbox.


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