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Serum Lactate Increase During Acute Asthma TreatmentSerum Lactate in Acute Asthma: A New Piece of the Puzzle

Gustavo J. Rodrigo, MD
Author and Funding Information

From the Departamento de Emergencia, Hospital Central de las Fuerzas Armadas.

Correspondence to: Gustavo J. Rodrigo, MD, Departamento de Emergencia, Hospital Central de las Fuerzas Armadas, Av 8 de Octubre 3020, Montevideo 11600, Uruguay; e-mail: gustavo.javier.rodrigo@gmail.com


Financial/nonfinancial disclosures: The author has reported to CHEST the following conflicts of interest: Dr Rodrigo has received compensation for participating as a lecturer and speaker in scientific meetings and courses under the sponsorship of AstraZeneca, Boehringer Ingelheim GmbH, GlaxoSmithKline, Esteve, Merck Sharp & Dohme Corp, and Novartis AG and received consulting fees from Air Products and Chemicals, Inc; Almirall SA; Boehringer Ingelheim GmbH; and Novartis AG.

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


Chest. 2014;145(1):6-7. doi:10.1378/chest.13-2042
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The occurrence of a transient increase in serum lactate level (hyperlactatemia) with or without lactic acidosis during short-term asthma treatment has been a well-known event for several decades. Although initially observed in patients with asthma and respiratory failure,2-4 there are now data on its occurrence in patients with less severe conditions and in patients receiving IV or nebulized salbutamol.5-8 Far from being an exceptional phenomenon, the prevalence of hyperlactatemia is much more frequent than previously estimated. Thus, two prospective observational studies involving adults and children with acute asthma in the emergency setting found that between 50% and 80% of patients presented with hyperlactatemia (serum lactate level > 2.2 mmol/L).6,8 Despite these findings, the pathophysiology and clinical significance of this phenomenon remains controversial.

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