scott@vtx-cpd.com
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Replying to Tascha B. 24/08/2022 - 08:01
Hello.
Great question. I have popped below the reference intervals for the EPOC machine. Obviously these are specific to this analyser but will help a bit from a range point of view:
An increase in blood lactate implies increased anaerobic metabolic activity, plus or minus a decrease in hepatic utilization and, to a lesser extent, renal excretion. The most common cause for an increased value is local or systemic hypoperfusion. Systemic hypoperfusion means that blood flow to the tissue is suboptimal. So, there are other factors apart from the hypovolaemia that can have an effect.
It has been suggested that the degree of hyperlactataemia is directly associated with the severity of hypoperfusion. Mild hypoperfusion is typically associated with lactate values of 3 to 5 mmol/L, moderate with values of 5 to 7 mmol/L, and severe with values above 7 mmol/L. Therefore, any elevation should first lead to the suspicion of hypoperfusion and incite an investigation as to the cause and how to correct it. However, many other causes of hyperlactatemia exist and should not be overlooked. Oxygen delivery to the tissue involves not only blood flow but also oxygenation of the blood, hemoglobin concentration and function, and the rate that tissues are using the oxygen. Therefore, other causes of hyperlactataemia that should be considered include problems with ventilation, arterial oxygen content, and hemoglobin concentration and an increased metabolic rate in tissue.
The main thing is to put it in the context of the patient. And the most important thing is not to make any decisions based on one value. The trend in the value is much more important than anything else.
Hope that helps.
Scott 🙂