Quantitative Assessment of Blood Lactate in Shock: Measure of Hypoxia or Beneficial Energy Source

Table 1

Human whole-body circulatory lactate and glucose turnover, oxidation, and clearance. Two fundamentally different pharmacokinetic methods are listed: (1) unlabeled (“cold”) either as a “bolus” or as a “constant infusion” which measures the net lactate uptake and (2) tracer (either ¹³C or ¹⁴C) either as a bolus dose or as a constant infusion which measures lactate carbon exchange.

Ref	Method	Condition	Blood lactate (mM)	Lactate turnover (μm/kg/min)	Glucose turnover	Lactate to CO2	Lactate to glucose	Clearance (L/min/70 kg)
[59]	^13C bolus	Normal rest	0.84	23		49%		1.89
		Exercise light	1.5	45		81%		2.1
		Exercise mild	4.5	58		78%		0.9
[61]	^14C constant	Normal rest	ND	18		85%	8%
[58]	^14C constant	Normal rest	0.65	15	11.4		21%	1.62
		Obese rest	0.6	12	7.65		22%	1.4
[63]	^14C constant	Normal rest	0.72	14.4				1.4
		Exercise light	≈1.0	32.8				2.3
		Exercise mild	≈1.5	59.1				2.8
		Exercise heavy	≈4.0	120				2.1
[166]	^13C constant	Normal rest	1.37	28	12.6			1.43
		Exercise mild	2.94	95	44.8			2.26
		Exercise heavy	5.22	136				1.83
	+ Infuse lactate	Normal rest	4.35	65	11			1.04
		Exercise mild	4.88	129	34.4			1.85
[57]	^14C constant	Normal rest	0.6	10.3	9.8	61%	15%	1.2
		Diabetic	1.1	14.9	12.9	51%	17%	0.95
[60]	^13C constant	Normal rest	0.9	11.2	7.2	65%	10%	0.84
		Septic shock	3.2	26.2	14.8	54%	15%	0.76
		Cardiac shock	2.8	26.6	15	43%	9%	0.68
[62]	^14C constant	Normal rest	ND	11.2
[64]	^13C constant	Normal rest	0.9	16		45%		1.24
	+ Lactate	Rest	4.0	53		32%		0.93
	+ Lactate	Exercise	6.96	221		100%		2.23
[93]	^13C constant	Rest	0.7	18.5		40%		1.85
		Exercise mild	2.5	214		90%		5.9
		Exercise heavy	7	357		70%		3.6
[67]	Cold bolus	Normal rest	0.7	13.2				1.32
[167]	Cold bolus	Normal rest	0.7	10.2				1.02
[168]	Cold bolus	Normal rest	0.53	7.4				0.98
[139]	Cold bolus	Normal rest	0.95	9.8	10.8	55%	18.5%	0.72
		Cardiac shock	6.7	33.6	29.5	61%	7.2%	0.54
[110]	Cold bolus	Normal rest	1.2	19.6				1.14
		Septic shock	2.6	19.9				0.53
[122]	Cold constant infusion	Normal rest	0.8	8.7				0.76
		Endotoxin shock	1.3	13.9				0.74