Lactate Measurement – Definition and Clinical Use
Lactate measurement is a diagnostic procedure used to determine the concentration of lactate in the blood. It helps assess tissue oxygenation and is widely used in emergency medicine and sports diagnostics.
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Lactate measurement is a diagnostic procedure used to determine the concentration of lactate in the blood. It helps assess tissue oxygenation and is widely used in emergency medicine and sports diagnostics.
What is Lactate Measurement?
Lactate measurement is a laboratory diagnostic procedure that determines the concentration of lactate (lactic acid) in the blood or plasma. Lactate is a metabolic byproduct produced when the body generates energy without sufficient oxygen supply – a process known as anaerobic glycolysis. The test provides critical information about tissue oxygen status and is used in both clinical emergency medicine and sports performance diagnostics.
How Does Lactate Measurement Work?
A small sample of venous or arterial blood is collected for analysis. In sports medicine, capillary blood from the earlobe or fingertip is commonly used. The sample is then analyzed enzymatically, where lactate is converted using the enzyme lactate oxidase or lactate dehydrogenase (LDH), and measured photometrically or electrochemically.
Reference Values
- Normal (resting): 0.5 – 2.2 mmol/L
- Mild exertion: up to approx. 4 mmol/L
- Elevated (lactic acidosis): above 5 mmol/L
- Critically elevated: above 10 mmol/L
When is Lactate Measurement Used?
Lactate measurement is applied in various clinical and sports medicine settings:
- Emergency medicine: Detection and severity assessment of shock, sepsis, or cardiovascular failure
- Intensive care: Monitoring of tissue oxygenation in critically ill patients
- Sports medicine and performance diagnostics: Determination of the anaerobic threshold to optimize training
- Suspected lactic acidosis: e.g. in diabetes mellitus under metformin therapy or in inherited metabolic disorders
- Liver function assessment: Since the liver metabolizes lactate, elevated values may indicate impaired liver function
Clinical Significance of Elevated Lactate Levels
An elevated blood lactate level is referred to as hyperlactatemia. When values rise significantly and blood pH decreases simultaneously, the condition is called lactic acidosis, which can be life-threatening and requires immediate medical intervention.
Possible causes of elevated lactate levels include:
- Shock (cardiogenic, septic, hemorrhagic)
- Severe infections and sepsis
- Heart failure
- Acute liver failure
- Intense physical exercise
- Metformin-associated lactic acidosis
- Inherited mitochondrial disorders
Lactate Measurement in Sports Medicine
In sports medicine and performance diagnostics, lactate measurement is used as part of a lactate step test. During this test, blood samples are collected at progressively increasing exercise intensities (e.g. on a treadmill or cycle ergometer) and lactate concentrations are measured. The resulting lactate performance curve is used to determine individual training zones and the anaerobic threshold – the point at which the body can no longer rely primarily on aerobic energy production.
References
- Vincent JL et al. – Lactate beyond oxygen debt and acidosis. Intensive Care Medicine, 2020.
- Mikkelsen ME et al. – Serum lactate is associated with mortality in severe sepsis independent of organ failure and shock. Critical Care Medicine, 2009.
- Heck H, Schulz H – Methods of lactate determination and their significance in sports medicine. Deutsche Zeitschrift fur Sportmedizin, 2002.
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