CARDIOPULMONARY MONITORINGBlood lactate levels in sepsis: in 8 questionsVincent, Jean-Louisa; Bakker, Janb,c,d,eAuthor Information aDepartment of Intensive Care, Erasme Hospital, Université libre de Bruxelles, Brussels, Belgium bDepartment of Intensive Care, Erasmus MC – University Medical Center, Rotterdam, The Netherlands cDepartment of Pulmonology and Critical Care, New York University NYU Langone Medical Center dDepartment of Pulmonology and Critical Care, Columbia University Medical Center, New York, USA ePontificia Universidad Católica de Chile, Department of Intensive Care, Santiago, Chile Correspondence to Jean-Louis Vincent, MD, PhD, Department of Intensive Care, Erasme Hospital, Route de Lennik 808, 1070 Brussels, Belgium. E-mail: [email protected] Current Opinion in Critical Care: June 2021 - Volume 27 - Issue 3 - p 298-302 doi: 10.1097/MCC.0000000000000824 Buy Metrics Abstract Purpose of review Blood lactate concentrations are frequently measured in critically ill patients and have important prognostic value. Here, we review some key questions related to their clinical use in sepsis. Recent findings Despite the metabolic hurdles, measuring lactate concentrations remains very informative in clinical practice. Although blood lactate levels change too slowly to represent the only guide to resuscitation, serial lactate levels can help to define the patient's trajectory and encourage a review of the therapeutic strategy if they remain stable or increase over time. Summary Lactate concentrations respond too slowly to be used to guide acute changes in therapy, but can help evaluate overall response. Hyperlactatemia should not be considered as a problem in itself, but as a warning of altered cell function. Copyright © 2021 Wolters Kluwer Health, Inc. All rights reserved.