A perspective on Serum Lactic acid, Lactic Acidosis in a Critical Care Unit

Agela A.Elbadri, A.A.Alshaari, D.S.Sheriff*

Benghazi University, Benghazi, Libya

*Corresponding author: Dr. D.S.Sheriff. Department of Biochemistry, Faculty of Medicine, Benghazi University. Benghazi, Libya. E-mail: dhastagir@yahoo.ca

Published: June 25, 2013


Breast cancer is one of the major surgical problems encountered in Libya. Lactic acidosis is a universal complication in breast cancer patients and can be considered a possible prognostic marker. Therefore, it will be beneficial to correctly understand and review the biochemistry underlying lactic acidosis and its possible significance as a prognostic marker in critical care patients, including breast cancer.

lactic acidosis; critical care patients.
  1. El Mistiri M, Verdecchia A, Rashid I, El Sahli N, El Mangush M, Federico M. Cancer incidence in eastern Libya: the first report from the Benghazi Cancer Registry, 2003. Int J Cancer 2007; 120(2):392-7.
  2. Sheriff DS. Lactic acidosis and small cell carcinoma of the lung. Postgrad Med J 1986; 62(726):297-8.
  3. Cohen R, Woods H. Clinical and Biochemical Aspects of Lactic Acidosis. Blackwell Scientific Publications; 1976.
  4. Philp A, Macdonald AL, Watt PW. Lactate—a signal coordinating cell and systemic function. J Exp Biol 2005; 208(Pt 24):4561–75.
  5. Huckabee WE. Relationships of pyruvate and lactate during anaerobic metabolism. I. Effects of infusion of pyruvate or glucose and of hyperventilation. J Clin Invest 1958; 37(2):244–54.
  6. Levy B. Lactate and shock state: the metabolic view. Curr Opin Crit Care 2006; 12(4):315–21.
  7.  Levraut J, Ciebiera JP, Chave S, et al. Mild hyperlactatemia in stable septic patients is due to impaired lactate clearance rather than overproduction. Am J Respir Crit Care Med 1998; 157(4 Pt 1):1021–6.
  8.  Bellomo R. Bench-to-bedside review: lactate and the kidney. Crit Care 2002; 6(4):322–6.
  9.  Bihari D, Gimson AE, Lindridge J, Williams R. Lactic acidosis in fulminant hepatic failure. Some aspects of pathogenesis and prognosis. J Hepatol 1985; 1(4):405–16.
  10.  Vary TC. Sepsis-induced alterations in pyruvate dehydrogenase complex activity in rat skeletal muscle: effects on plasma lactate. Shock 1996; 6(2):89–94.
  11. Levy B, Sadoune LO, Gelot AM, Bollaert PE, Nabet P, Larcan A. Evolution of lactate/pyruvate and arterial ketone body ratios in the early course of catecholamine-treated septic shock. Crit Care Med 2000; 28(1):114–9.
  12. Revelly JP, Tappy L, Martinez A, Bollmann M, Cayeux MC, Berger MM, et al. Lactate and glucose metabolism in severe sepsis and cardiogenic shock. Crit Care Med 2005; 33(10):2235–40.
  13. Schulier JP, Nicaise C, Klastersky J. Lactic acidosis: a metabolic complication of extensive metastatic cancer. Eur J Cancer Clin Oncol 1983; 19(5):597-601.
  14. Spechler SJ, Esposite AL, Koff RS, Hang WK.  Lactic acidosis in oat cell carcinoma with extensive hepatic metastases. Arch Intern Med1978; 138(11):1663-4.
  15. Berry M, Schern J. Splanchnic lactic acid metabolism in hyperventilation, metabolic alkalosis and shock. Metabolism 1967; 16(6):537-47.
  16. Hsu PP, Sabatini DM. Cancer cell metabolism: Warburg and beyond. Cell 2008; 134(5):703-7.

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Int J Biomed. 2013; 3(2):129-131. © 2013 International Medical Research and Development Corporation. All rights reserved.