Hyperlactatemia

Hyperlactatemia is an elevated concentration of lactate in the blood. It can occur with or without metabolic acidosis, depending partly on accompanying changes in acid–base balance.

Lactate metabolism: The production, transport, and use of lactate in cells and tissues. A change in production or disposal can raise blood lactate.
Lactic acidosis: A form of metabolic acidosis associated with elevated lactate and an increased anion gap. Elevated lactate alone does not establish lactic acidosis.
Lactate: The anion formed when lactic acid loses a proton; it is also a normal metabolic intermediate. Blood lactate concentration is the defining measurement in hyperlactatemia.
Type A lactic acidosis: Lactic acidosis associated with inadequate tissue oxygen delivery or utilization. It is a traditional category for hypoperfusion-related lactate elevation.
Anaerobic glycolysis: The breakdown of glucose to pyruvate and lactate when glycolytic flux exceeds mitochondrial oxidation. Accelerated glycolysis can increase lactate production, including when oxygen is available.
Sepsis: Life-threatening organ dysfunction caused by a dysregulated response to infection. Sepsis can raise lactate through altered circulation, metabolism, and clearance.
Metabolic acidosis: An acid–base disorder in which a primary decrease in bicarbonate lowers blood pH. It may accompany hyperlactatemia, but the two findings are not interchangeable.
Type B lactic acidosis: Lactic acidosis occurring without evident systemic tissue hypoxia, often due to disease, drugs, or metabolic changes. It distinguishes non-hypoxic causes from the classic perfusion-related pattern.
Cori cycle: A metabolic cycle in which lactate from peripheral tissues is converted to glucose by the liver. Hepatic recycling is one route by which lactate is removed from blood.
Hypovolemic shock: Shock caused by a substantial loss of circulating blood or fluid volume. Poor tissue perfusion can drive lactate production in severe hypovolemia.

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