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Hyperlactatemia is defined as a persistent, mild to moderate (2-4 mmol/L) increase in blood lactate concentration without metabolic acidosis, whereas lactic acidosis is characterized by persistently increased blood lactate levels (usually >5 mmol/L) in association with metabolic acidosis.
A level above 4.0 mmol/L is associated with a 27% mortality rate, compared with a mortality rate of 7% for patients with a lactate level of 2.5-4.0 mmol/L and a death rate below 5% for those with a lactate level below 2.5 mmol/L, said Dr Strehlow of the university. Serial lactate measures also help assess response to therapy. The half-life of lactate is around 20 minutes, even in septic patients. If the lactate is persistently elevated, it's not because the body can't get rid of it, but because the body continues producing it, shifting to anaerobic metabolism. Six hours after treatment, patients whose lactate levels decrease by 10% have a mortality rate below 20%, compared with a greater than 50% chance of dying if the lactate level hasn't fallen, studies suggest.