Lactate and hemodynamic coherence in acute circulatory failure

Publication date: Available online 10 November 2016 Source:Best Practice & Research Clinical Anaesthesiology Author(s): Jan Bakker In this review the relationship between changes in macrohemodynamics during the development and treatment of acute circulatory failure will be discussed in the context of coherence with the microcirculation and changes in lactate. It seems that in models of circulatory failure coherence between changes in macrocirculatory perfusion and microcirculatory perfusion and coherence with subsequent changes in lactate levels are more or less preserved. However, in patients, especially those with septic shock, these relationships are much less clear. As many factors influence both the effect of circulatory failure and infection on the microcirculation and on lactate levels this should not be a surprise. Resuscitation should therefore be aiming at adequate tissue perfusion where the use of systemic hemodynamics, microcirculatory perfusion parameters and lactate levels should be used in their relevant context. This results in treating the individual patient as an n=1 experiment.
Source: Best Practice and Research Clinical Anaesthesiology - Category: Anesthesiology Source Type: research