Question

You are the nurse taking care of a septic patient in the medical intensive care unit....

You are the nurse taking care of a septic patient in the medical intensive care unit. The patient has been hypotensive for several hours despite appropriate treatment.

A.) Would you expect the patient’s lactate level to be high, low, or normal?

B.) Why?

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Answer #1

Lactate level will be high.

Patient is suffering from septic shock due to sepsis and hypotension.
In septic shock epinephrine is administered to patient. And this situation cause lactate elevation.

Rational:- Lactate elevation in sepsis due to endogenous epinephrine stimulating beta-2 receptors.
In skeletal muscle cells, this stimulation up regulates glycolysis, generating more pyruvate than can be used by the cell's mitochondria via the TCA cycle. Excess pyruvate is converted into lactate.

Lactate elevation process is totally aerobic.
It occur after all adequate oxygen delivery.

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