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How to interpret lactate
  1. Dilshad Marikar1,
  2. Pratusha Babu1,
  3. Miriam Fine-Goulden2
  1. 1Paediatric Department, Addenbrooke’s Hospital, Cambridge, UK
  2. 2Paediatric Intensive Care Unit, Evelina London Children’s Hospital, Guy's & St. Thomas' NHS Foundation Trust, London, UK
  1. Correspondence to Dr Miriam Fine-Goulden, Paediatric Intensive Care, Evelina London Children's Hospital, London SE1 7EH, UK; miriam.finegoulden{at}


The association between hyperlactataemia and poorer outcomes in acutely unwell adults and children is well recognised. Blood lactate testing has become readily available in acute settings and is considered a first-line investigation in international guidelines for the management of sepsis. However, while healthcare professionals do appreciate the value of measuring blood lactate in acute severe illness, its clinical significance and interpretation remain less well understood. In this paper, we present the evidence for the use of lactate as a diagnostic test and prognostic marker in acutely unwell children.

  • biochemistry
  • physiology
  • neonatology
  • resuscitation

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  • Twitter @MDMarikar, @docprabu, @finegoulden

  • Contributors DM and PB: initial manuscript draft. MF-G, DM and PB: manuscript revisions. PB and MF-G produced the figures and DM the infographic. DM produced statistical summary tables. This is an update of an article originally published in ADCE&P by MF-G in 2014.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Patient consent for publication Not required.

  • Provenance and peer review Commissioned; externally peer reviewed.