Objective: To investigate the acid-base abnormalities of the patients with hyperlactatemia and explore the relationship of hyperlactatemia and metabolic acidosis so as to seek a more precise index of reflecting organ perfusion.
Methods: From August 2009 to April 2010, all consecutive patients admitted into intensive care unit received an analysis of blood gas. Those individuals with arterial lactate ≥ 2 mmol/L were selected.
Results: In the group of hyperlactatemic patients, the occurrence of metabolic acidosis as judged by the traditional method was less than that by the Stewart's method (33.9% vs 56.0%). No typical acidemia was found. And all components of metabolic acidosis were calculated. Lactate and SIG (strong ion gap) contributed a certain percentage to metabolic acidosis in the survivor and nonsurvivor groups [(33.6 ± 17.9)% vs (28.6 ± 23.5)%, (42.1 ± 18.5)% vs (44.9 ± 23.0)%].
Conclusion: Among the hyperlactatemic patients (Lac ≥ 2), lactate and unmeasured anions account for most instances of acidosis. These two indicators may offer a more accurate reflection of tissue perfusion.