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Hyperlactatemia: Sensitivity and Specificity

Introduction: From eMedicine: "The normal blood lactate concentration in unstressed patients is 1-0.5 mmol/L. Patients with critical illness can be considered to have normal lactate concentrations of less than 2 mmol/L. Hyperlactatemia is defined as a mild-to-moderate persistent increase in blood lactate concentration (2-5 mmol/L) without metabolic acidosis, whereas lactic acidosis is characterized by persistently increased blood lactate levels (usually >4-5 mmol/L) in association with metabolic acidosis." [http://emedicine.medscape.com/article/768159-overview]

See also Mortality in Sepsis, which is correlated with rising lactate.

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Tags: Metabolic Tag this Diagnosis.

The sensitivity and specificity of findings for Hyperlactatemia are listed below. See the left navigation bar to change the display.

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Finding SensitivitySpecificity Comments, Study
Albmuin-Corrected Anion Gap Edit 32.3%79.7%

ACAG > 12 for lactate >= 2mmol/l

Study: J Intensive Care Med. 2008 Mar-Apr;23(2):122-7. PMID: 18431828

Anion Gap Edit 14.5%93.5%

AG > 12 for lactate >= 2mmol/l

Study: J Intensive Care Med. 2008 Mar-Apr;23(2):122-7. PMID: 18431828

Base Deficit Edit 64.7%52.9%

BD > 2 for lactate >= 2mmol/l

Study: J Intensive Care Med. 2008 Mar-Apr;23(2):122-7. PMID: 18431828