Elevated Lactate Levels in a Non–Critically Ill Patient

Lactic acidosis can occur in the presence (type A) or absence (type B) of tissue hypoperfusion. In diagnosing states of tissue hypoperfusion, blood lactate testing is generally highly sensitive but has poor specificity. In the case of mesenteric ischemia, for example, the sensitivity of elevated lac...

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Bibliographic Details
Published in:JAMA : the journal of the American Medical Association 2015-02, Vol.313 (8), p.849-850
Main Authors: Chen, Meng, Kim, Tiffany Y, Pessegueiro, Antonio M
Format: Article
Language:English
Subjects:
Acidosis, Lactic - diagnosis
Acidosis, Lactic - etiology
Blood Cell Count
Blood Chemical Analysis
Humans
Lactates - blood
Lymphatic Diseases - diagnostic imaging
Lymphatic Diseases - etiology
Lymphoma - complications
Lymphoma - diagnosis
Male
Medical diagnosis
Medical treatment
Middle Aged
Radiography
Risk factors
Tissues
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Summary:Lactic acidosis can occur in the presence (type A) or absence (type B) of tissue hypoperfusion. In diagnosing states of tissue hypoperfusion, blood lactate testing is generally highly sensitive but has poor specificity. In the case of mesenteric ischemia, for example, the sensitivity of elevated lactate levels for establishing the diagnosis is as high as 100%, whereas the specificity is only 42%.1 Thus, it is common to have an elevated lactate level due to reasons other than tissue hypoperfusion, but rare to have a normal lactate level in the presence of tissue hypoperfusion. Here, Chen et al discuss the symptoms and diagnostic approach of lactic acidosis.
ISSN:0098-7484
1538-3598
DOI:10.1001/jama.2014.14074