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Excess Lactate: An Index of Reversibility of Shock in Human Patients.

Max H. Weil, M.D., F.A.C.P.; George Broder, M.D.; and Frank Cramer, B.S.
Ann Intern Med. 1964;60(4):711. doi:10.7326/0003-4819-60-4-711_1
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"Excess lactate," an indicator of oxygen debt, has been studied as a metabolic index of the severity of the shock state in human patients. Serial hemodynamic and metabolic measurements were performed in 56 patients who had hypotension and clinical features of shock due to blood or fluid loss, myocardial infarction, overwhelming infection, and pulmonary embolization. Lactic and pyruvic acid concentrations were measured in arterial blood and the "excess lactate" (XL) was calculated as defined by Huckabee. Eighty-two per cent of patients in whom XL was in the normal range, that is less than 1 mM/liter, survived. Survival decreased to 60%



lactates ; shock

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