Podcast 608: Another Elevated Lactate?

Podcast 608: Another Elevated Lactate?

Contributor: Jared Scott, MD

Educational Pearls:

  • Lactate is a byproduct of anaerobic metabolism or tissue hypoperfusion
  • Though typically associated with severe sepsis, hyperlactatemia can be caused by vigorous exercise, seizures, liver failure, asthma exacerbations, albuterol, metformin, antiretroviral drugs, and propofol
  • Liver failure can lead to an inability to clear lactate, or convert it back to glucose byproducts, instead of an overproduction of lactate
  • Always remember the other causes of elevated lactic acid besides sepsis but also remember sepsis!

References:

Kraut JA, Madias NE. Lactic acidosis. N Engl J Med. 2014 Dec 11;371(24):2309-19. doi: 10.1056/NEJMra1309483. PMID: 25494270.

Wardi G, Brice J, Correia M, Liu D, Self M, Tainter C. Demystifying Lactate in the Emergency Department. Ann Emerg Med. 2020 Feb;75(2):287-298. doi: 10.1016/j.annemergmed.2019.06.027. Epub 2019 Aug 29. Erratum in: Ann Emerg Med. 2020 Apr;75(4):557. PMID: 31474479.

Summarized by Jackson Roos, MS4 | Edited by Erik Verzemnieks, MD


The Emergency Medical Minute is excited to announce that we are now offering AMA PRA Category 1 credits™ via online course modules. To access these and for more information, visit our website at www.emergencymedicalminute.com/cme-courses/ and create an account.

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Podcast 875: A Pediatric Case of Myopericarditis

Podcast 875: A Pediatric Case of Myopericarditis

Contributor: Meghan Hurley MD Educational Pearls: Pericarditis is inflammation of the pericardial sac, which can arise from infectious or non-infectious etiologies Myocarditis is inflammation of t...

30 Okt 20236min

Episode 874: Bradyarrhythmias

Episode 874: Bradyarrhythmias

Contributor: Dylan Luyten MD Educational Pearls: What is a Bradyarrhythmia? Also known as a bradyarrhythmia, it is an irregular heart rate that is also slow (below 60 beats per minute). What can c...

23 Okt 20232min

Podcast 873: Intravesical Tranexamic Acid for Gross Hematuria

Podcast 873: Intravesical Tranexamic Acid for Gross Hematuria

Contributor: Aaron Lessen MD Educational Pearls: Tranexamic acid (TXA) is a common medication to achieve hemostasis in a variety of conditions Patients visiting the ED for gross hematuria (between...

16 Okt 20232min

Podcast 872: Preseptal and Orbital Cellulitis

Podcast 872: Preseptal and Orbital Cellulitis

Contributor: Meghan Hurley MD Educational Pearls: What is Cellulitis? A common and potentially serious bacterial skin infection. Caused by various types of bacteria, with Streptococcus and Staphyl...

9 Okt 20234min

Mental Health Monthly #17: Mania

Mental Health Monthly #17: Mania

Contributors: Andrew White MD - Outpatient Psychiatrist; Fellowship Trained in Addiction Psychiatry; Denver Health Travis Barlock MD - Emergency Medicine Physician; Swedish Medical Center Summary In t...

5 Okt 202340min

Podcast 871: Increased Intracranial Pressure and the Cushing Reflex

Podcast 871: Increased Intracranial Pressure and the Cushing Reflex

Contributor: Travis Barlock MD Education Pearls: The Cushing Reflex is a physiologic response to elevated intracranial pressure (ICP) Cushing's Triad: widened pulse pressure (systolic hypertensio...

2 Okt 20233min

On The Streets #15: Hydrofluoric Acid Case Review

On The Streets #15: Hydrofluoric Acid Case Review

Contributors: Kalen Abbott, MD - EM Physician and Medical Director for AirLife Denver Brendan Reiss - Flight Nurse AirLife Denver Matt Spoon - Flight Paramedic AirLife Denver Jordan Ourada - E...

29 Sep 202341min

Episode 870: Advanced Trauma Life Support (ATLS)

Episode 870: Advanced Trauma Life Support (ATLS)

Contributor: Meghan Hurley MD Educational Pearls: What is ATLS? Advanced Trauma Life Support (ATLS) is a systematic and comprehensive approach to the evaluation and management of trauma patients I...

25 Sep 20237min

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