Lactate in extracorporeal circulation: myths and facts.

Abstract

The interpretation, analysis and management strategies of lactate in patients undergoing Extracorporeal Circulation during the last decade has changed, due to the advent of new measurement technologies and deep understanding of the metabolism of carbohydrates in humans, this molecule has changed from being just a villain to an alternative source of energy in special physiological moments, one of them being the ECC, in which the neuroendocrine response to stress and the inflammatory response to contact of a non-endothelialized surface biologically, make the responses and biochemical manifestations not fully understood. The molecule of lactate and its increases in ECC, does not escape this response, its bimodal presentation and its normalization in the short term, has generated many times misguided approaches by the specialists involved in the entire perioperative process of the patient submitted to CEC. The main focus of this review is to clarify the myths and show the real facts in the light of current knowledge.