Lactate in Sepsis: Pearls & Pitfalls…

Despite the ongoing controversy regarding the optimal endpoints of early sepsis resuscitation and the source of hyperlactemia, lactate remains the best non-invasive marker of illness severity. Given the current data, a ≥ 10% lactate clearance at 6 hours is an appropriate marker to follow when resuscitating a septic patient. However, recent research by Puskarich et al. showed that lactate normalization to < 2.0 mmol/L within the first 6 hours of resuscitation is superior to the rate of clearance.