Lactate production and measurement in critically ill horses.

The research article is about understanding the factors contributing to increased lactate levels in critically ill horses and the methods used for its measurement. The focus is on how tissue metabolism, inflammation, liver disease and other conditions can contribute to high lactate levels.

Overview

The article investigates the role of blood lactate concentration in equine patients. Lactate is typically produced under conditions of inadequate oxygen delivery to the tissues, also known as anaerobic metabolism. Furthermore, blood lactate levels can also rise in conditions of apparent adequate oxygen delivery, particularly in cases of sepsis and intense inflammation.

Lactate Production Mechanisms

• The article suggests several probable mechanisms for an increase in lactate production even under aerobic conditions. One of these mechanisms includes the heightened activity of the sodium-potassium pump (Na+/K+-ATPase) triggered by inflammatory mediators in the body.
• Inhibition of pyruvate dehydrogenase, an essential enzyme involved in glucose metabolism, is also identified as another potential cause of increased lactate production.
• Lastly, the study mentions increased lactate production by activated inflammatory cells.

Lactate Metabolism

• Lactate metabolism is primarily regulated by the liver, indicating that liver disease could potentially increase blood lactate concentration.
• Though the skeletal muscle is usually considered the major source of lactate in conditions like sepsis, the roles of lungs and the gastrointestinal tract in lactate production have also been discussed, with their exact contribution remaining uncertain.
• The process of lactate measurement is simple and cost-effective using available point-of-care meters, highlighting how critical measurements can be easily managed even in field settings.