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.

Avsnitt(1145)

Podcast 767: Transaminitis and Rhabdomyolysis

Podcast 767: Transaminitis and Rhabdomyolysis

Contributor: Sam Killian, MD Educational Pearls: Transaminitis refers to the elevation of transaminases, enzymes of the liver (AST and ALT) Elevation of ALT is relatively specific to the liver, but A...

28 Mars 20223min

Podcast 766: Truth about Tramadol

Podcast 766: Truth about Tramadol

Contributor: Aaron Lessen, MD Educational Pearls: Tramadol is often thought of as a mild-opiate to use for analgesia, but it is a more complicated drug Tramadol needs to be metabolized into an effect...

22 Mars 20223min

Podcast 765: Phenobarbital for Alcohol Withdrawal

Podcast 765: Phenobarbital for Alcohol Withdrawal

Contributor: Aaron Lessen, MD Educational Pearls: Retrospective cohort study looked at return rate of discharged patients after receiving either phenobarbital or benzodiazepines or both in the ED for...

21 Mars 20222min

Podcast 764: Myth or Merit: Beta-Blockers for Cocaine Chest Pain

Podcast 764: Myth or Merit: Beta-Blockers for Cocaine Chest Pain

Contributor: Chris Holmes, MD Educational Pearls: Many are taught that patients with cocaine chest pain should not receive beta-blockers due to unopposed alpha agonism, but is this true? 363 consecut...

15 Mars 20223min

Podcast 763: Sternoclavicular Infection

Podcast 763: Sternoclavicular Infection

Contributor: Aaron Lessen, MD Educational Pearls: Septic arthritis can occur at any joint, including the sternoclavicular joint Sternoclavicular joint infections comprise 1% of all bone and joint inf...

14 Mars 20223min

UnfilterED #14: Patricia Hernandez, MSIV and Leyanet Gonzalez, MSIV

UnfilterED #14: Patricia Hernandez, MSIV and Leyanet Gonzalez, MSIV

Tune in for a double feature with our Equity, Diversity and Inclusion Award winners from this fall as Nick asks them about their backgrounds, what brought them into medicine and Emergency Medicine spe...

9 Mars 202250min

Podcast 762: Endocarditis

Podcast 762: Endocarditis

Contributor: Jared Scott, MD Educational Pearls: Variability of organisms in infecting the myocardial valves Duke Criteria for Infective Endocarditis includes three categories that can be used to def...

8 Mars 20225min

Podcast 761: Peritonsillar Abscess: To Stab or Not to Stab?

Podcast 761: Peritonsillar Abscess: To Stab or Not to Stab?

Contributor: Jared Scott, MD Educational Pearls: Often present with complaints of sore throat, pain with swallowing, difficulty swallowing, voice change, and possible fever Retrospective study from 2...

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