Hyperlactataemia in intensive care unit

Lactataemia represents plasma lactate concentration, which results from a balance between its production and its clearance. The normal value of lactataemia is < 1.5 mmol/L. In physiological conditions, lactate production is similar to its elimination, and represents an amount of 1500 mmol/day. Hyperlactataemias are classified into two groups, those caused by an oxygen deficit and those related to an increased turnover of the "aerobic'' glycolysis (called "stress hyperlactataemias''). Hyperlactataemia can also result from an impairment of its metabolisation and, in turn, to a reduction in its elimination. Admission and above all persistent hyperlactataemia remains a marker of poor prognosis and its repeated measurements must be totally included in the routine multimodal monitoring of patients in shock. Lactate is a useful energy substrate of multiple organs such as brain and heart, especially during shock. Due to various effects including energy supply, reduction in cell oedema, and vasodilation, the exogenous administration of sodium-lactate seems to be beneficial in various conditions of organ injuries.