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Solely Targeting “Alactatemia” in Septic Shock Resuscitation?Alactatemia in Septic Shock Resuscitation?: Let’s Be Cautious—It’s Not So Simple

H. Bryant Nguyen, MD; Vi Am Dinh, MD
Author and Funding Information

From the Departments of Emergency Medicine and Medicine, Critical Care, Loma Linda University.

Correspondence to: H. Bryant Nguyen, MD, Loma Linda University, 11234 Anderson St, A108, Loma Linda, CA 92354; e-mail: hbnguyen@llu.edu


Financial/nonfinancial disclosures: The authors have reported to CHEST that no potential conflicts of interest exist with any companies/organizations whose products or services may be discussed in this article.

Reproduction of this article is prohibited without written permission from the American College of Chest Physicians. See online for more details.


Chest. 2013;143(6):1521-1523. doi:10.1378/chest.13-0006
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Lactate has been studied for decades as a prognostic marker of resuscitation and patient outcome in shock. While the mechanism for lactate elevation is debatable, it has been known since the 1960s that a lactate value > 4 mM in the critically ill patient is associated with increased mortality.1 Additionally, lactate clearance, or the decrease in lactate level as a goal during resuscitation, has been examined and re-examined for the past 3 decades.

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