Approach to ... High Lactate DDx
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Approach to ... High Lactate DDx
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The provided text explains that lactate is a vital metabolic fuel and carbon source for the heart and brain, rather than just a waste product of oxygen deprivation. Clinicians categorize lactic acidosis into two types: Type A, which stems from inadequate tissue oxygenation, and Type B, which occurs due to metabolic triggers like medications, toxins, or systemic diseases. The liver and kidneys are responsible for the vast majority of lactate clearance, and disruptions in these organs can lead to dangerous accumulation. In the emergency department, measuring these levels serves as a critical prognostic tool for identifying patients in "cryptic shock" who may appear stable but face a high risk of death. Effective resuscitation is often marked by the body's ability to normalize these levels, making lactate a key indicator for monitoring treatment success in severe illness. Consequently, understanding the nuanced causes of hyperlactatemia helps medical providers differentiate between benign temporary elevations and life-threatening physiological stress.
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