Lactate as a biomarker of cell perfusion in Intensive Care Units Lactato como biomarcador de perfusión celular en las Unidades de Terapia Intensiva Literature review

Abstract

Shock an acute clinical pathology characterized by an imbalance between the availability and consumption of oxygen at the cellular level, being able to reach a critical point called tissue hypoxia. Failure to correct the primary disorder can cause multiorgan dysfunction and the death of the patient, hence the interest in finding a biomarker that reflects this complex process. Lactic acid or lactate currently corresponds to the cell perfusion marker most used in intensive care units due to its predictive superiority as a marker of poor prognosis confirmed in clinical studies versus other traditional markers in all types of shock. Lactate has detected a good relationship with mortality with a single initial measurement in the context of circulatory failure, predictive power of higher mortality if there is no 10% decrease in relation to initial lactate at 6 hours of resuscitation and more important. An early resuscitation guide is probably not the ideal biomarker as it is considered more of a chemical product of vital intermediate metabolism as an energy source in a context of tissue hypoxia, than a biomarker of cellular injury or dysfunction. However, its predictive power makes it a biomarker for deep study and insight.