Podcast 608: Another Elevated Lactate?

<p><strong>Contributor: Jared Scott, MD</strong></p> <p><strong>Educational Pearls:</strong></p> <ul> <li><span style="font-weight: 400;">Lactate is a byproduct of anaerobic metabolism or tissue hypoperfusion</span></li> <li><span style="font-weight: 400;">Though typically associated with severe sepsis, hyperlactatemia can be caused by vigorous exercise, seizures, liver failure, asthma exacerbations, albuterol, metformin, antiretroviral drugs, and propofol</span></li> <li><span style="font-weight: 400;">Liver failure can lead to an inability to clear lactate, or convert it back to glucose byproducts, instead of an overproduction of lactate</span></li> <li><span style="font-weight: 400;">Always remember the other causes of elevated lactic acid besides sepsis but also remember sepsis!</span></li> </ul> <p><strong>References:</strong></p> <p><span style="font-size: 10pt;"><span style= "font-weight: 400;">Kraut JA, Madias NE.</span> <a href= "https://pubmed.ncbi.nlm.nih.gov/25494270/"><span style= "font-weight: 400;">Lactic acidosis</span></a><span style= "font-weight: 400;">. N Engl J Med. 2014 Dec 11;371(24):2309-19. doi: 10.1056/NEJMra1309483. PMID: 25494270.</span></span></p> <p><span style="font-size: 10pt;"><span style= "font-weight: 400;">Wardi G, Brice J, Correia M, Liu D, Self M, Tainter C.</span> <a href= "https://pubmed.ncbi.nlm.nih.gov/31474479/"><span style= "font-weight: 400;">Demystifying Lactate in the Emergency Department.</span></a> <span style="font-weight: 400;">Ann Emerg Med. 2020 Feb;75(2):287-298. doi: 10.1016/j.annemergmed.2019.06.027. Epub 2019 Aug 29. Erratum in: Ann Emerg Med. 2020 Apr;75(4):557. PMID: 31474479.</span></span></p> <p><span style="font-size: 10pt;"><em><span style= "font-weight: 400;">Summarized by Jackson Roos, MS4 | Edited by Erik Verzemnieks, MD</span></em></span></p> <p><br /> <span style="font-weight: 400;">The Emergency Medical Minute is excited to announce that we are now offering</span> <em><span style="font-weight: 400;">AMA PRA Category 1 credits™</span></em> <span