Lactate Monitoring in Intensive Care: A Comprehensive Review of Its Utility and Interpretation

Lactate monitoring is critical in managing critically ill patients in intensive care settings. Elevated lactate levels often signify underlying metabolic disturbances such as tissue hypoxia, anaerobic metabolism, or impaired lactate clearance, which are prevalent in conditions like sepsis, shock, and trauma. Understanding the physiological basis of lactate production and its significance in clinical practice is essential for interpreting its diagnostic and prognostic value. This comprehensive review aims to explore the utility of lactate monitoring across various critical care scenarios. It provides an overview of lactate's metabolic pathways, methods of measurement, and the clinical implications of interpreting lactate levels in different contexts. Additionally, the review discusses current evidence on lactate-guided therapeutic interventions and highlights challenges and limitations to their application. By synthesizing the existing literature and clinical insights, this review aims to enhance the understanding of the role of lactate monitoring in assessing disease severity, guiding treatment strategies, and predicting outcomes in critically ill patients. Ultimately, this review underscores the importance of integrating lactate monitoring into routine clinical practice to optimize patient care and improve clinical outcomes in intensive care settings.