Clinical use of lactate testing in shock states

Venous lactate is a valuable diagnostic test for the evaluation of shock and suspected shock states. Lactate level has been found to correlate with poor prognosis in perioperative, intraoperative, SICU, MICU, and Emergency Department patients, even when vital signs are normal. Patients who respond to resuscitative measures with a decrease in lactate level have a better prognosis than those with persistently elevated lactate levels. In interpreting lactate values it is important to be aware of clinical states, especially liver disease and antiretroviral therapy, which can cause elevations of lactate in the absence of hypoperfusion.