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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.

Specific Findings

Finding SensitivitySpecificity Comments, Study
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

Poorly Diagnostic Findings

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

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