The origins of the Lacto-Bolo reflex: the mythology of lactate in sepsis.

Sepsis lactate metabolic failure myth septic shock the Lacto-Bolo reflex

Journal

Journal of thoracic disease
ISSN: 2072-1439
Titre abrégé: J Thorac Dis
Pays: China
ID NLM: 101533916

Informations de publication

Date de publication:
Feb 2020
Historique:
entrez: 10 3 2020
pubmed: 10 3 2020
medline: 10 3 2020
Statut: ppublish

Résumé

The use of lactate as a marker of the severity of circulatory shock was popularized by Dr. Weil in the 1970's. Dr. Weil promoted the idea that blood lactate concentration increased in circulatory shock due to anaerobic metabolism following decreased oxygen delivery. This concept becomes entrenched with 1992 ACCP/SCCM consensus conference definition of sepsis. Since then, the central role of lactate in the definition and management of septic shock has only been expanded and become more ingrained. This review will discuss the wisdom of such an approach, an updated model describing the origins of hyperlactatemia in sepsis, and how such improvements in our knowledge of the underlying physiology should change our approach to resuscitation in patients presenting with septic shock.

Identifiants

pubmed: 32148925
doi: 10.21037/jtd.2019.11.48
pii: jtd-12-S1-S48
pmc: PMC7024759
doi:

Types de publication

Journal Article Review

Langues

eng

Pagination

S48-S53

Informations de copyright

2020 Journal of Thoracic Disease. All rights reserved.

Déclaration de conflit d'intérêts

Conflicts of Interest: The authors have no conflicts of interest to declare.

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Auteurs

Rory Spiegel (R)

Department of Critical Care and Department of Emergency Medicine, Georgetown University Medstar Washington Hospital Center, Washington, DC, USA.

David Gordon (D)

Department of Pulmonary and Critical Care, University of Maryland Medical Center, Baltimore, MD, USA.

Paul E Marik (PE)

Department of Internal Medicine, Pulmonary and Critical Care Medicine, Eastern Virginia Medical School, Norfolk, VA, USA.

Classifications MeSH