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Latest Edit: Hector 2014-03-24 (EDT)

See Also Lab Tests

Lactate, or lactic acid testing is useful to obtain and quantify the degree of tissue hypoxemia associated with shock or localized vascular occlusion. It can also help to measure the degree of success associated with the treatment of those conditions. [1], [2]


  • Under normal physiological conditions and oxygen availability to tissues, glucose is metabolized to CO2 and H2O for energy. When oxygen to the tissues is depleted, anaerobic metabolism of glucose occurs and lactate (lactic acid) is formed instead of CO2 and H2O.
  • Consequently, when the liver is hypoxic or lacking oxygen, it fails to clear the lactate, which causes it to accumulate and lead to lactic acidosis (LA).
  • Blood lactate is therefore a sensitive and reliable indicator of tissue hypoxia.

Patient Preparation

  • No fasting required.
  • Factors which can cause increased levels
  • The prolonged use of a tourniquet or clenching of hands, vigorous exercise
  • Drugs: cyanide, ethanol, aspirin, phenformin, and nalidixic acid.
  • Factors which can cause decreased levels
  • None noted

Clinical Implications

High levels indicate:

  • Tissue ischemia
  • Carbon monoxide poisoning
  • Severe liver disease
  • Genetic errors of metabolism
  • Diabetes mellitus (nonketotic)

Associated Tests

  • Arterial blood gases


  1. Pagana Kathleen D, Pagana Timothy J (2006) Mosby's Manual of Diagnostic and Laboratory Tests, Mosby.
  2. Weatherby Dicken, Ferguson Scott (2002) Blood Chemistry and CBC Analysis: Clinical Laboratory Testing from a Functional Perspective, Bear Mountain.