Lactate has long been recognized as a marker of illness severity in all situations of physiological stress, including sepsis. In sepsis, lactate is a powerful predictor of mortality. In a recent study, patients with isolated hyperlactatemia had 1.7 times the risk of 90-day mortality compared to patients with isolated hypotension. This predictive value has been recognized by the SEPSIS-3 consensus definition of shock, which requires the presence of hyperlactatemia.
Role of Lactate in Sepsis
Lactate is a normal product of glucose and amino acid metabolism, and its production increases during periods of physiological stress. In sepsis, lactate production is increased due to the body’s response to infection and inflammation. However, this does not necessarily mean that lactate is harmful. In fact, recent studies have shown that lactate may play a role in energy production and tissue protection during sepsis.