Understanding Hyperlactatemia in Sepsis: Are We There Yet?

High plasma lactate is a useful indicator of shock, a canary in the coal mine, that is associated with increased mortality in sepsis. But instead of a harmful molecule per se, lactate is a central molecule in the intra and interorgan exchange of carbon and redox potential. (1) The study by Gattinoni et al., who presented a novel approach to the analysis of data from the ALBIOS study, adds to the required change of paradigm concerning lactate metabolism in sepsis. (2) The authors nicely demonstrated that there are multiple reasons for hyperlactataemia in sepsis and that the increased snapshot value we measure, reflects an imbalance between increased production and reduced consumption...