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If elevated lactate is present in acute illness, supporting the oxygen supply and blood flow are key initial steps. [3] Some vasopressors (drugs that augment the blood pressure) are less effective when lactate levels are high, and some agents that stimulate the beta-2 adrenergic receptor can elevate the lactate further. [3]
Still, the blood values are approximately equal between the arterial and venous sides for most substances, with the exception of acid–base, blood gases and drugs (used in therapeutic drug monitoring (TDM) assays). [6] Arterial levels for drugs are generally higher than venous levels because of extraction while passing through tissues. [6]
Muscles are producing lactate even at rest, with resting blood lactate levels in the 1–2 mmol/L range. [6] Although the lactate threshold is defined as the point when lactic acid starts to accumulate, some testers approximate this by crossing the lactate threshold and using the point at which lactate reaches a concentration of 4 mmol/ L of ...
Here you can see a typical test where the first lactate threshold is at around 210-215 power output and their second lactate threshold is at 260-265.
A rise in lactate out of proportion to the level of pyruvate, e.g., in mixed venous blood, is termed "excess lactate", and is an indicator of anaerobic glycolysis occurring in muscle cells, as seen during strenuous exercise. Once oxygenation is restored, the acidosis clears quickly.
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If blood glucose concentrations are high, the glucose can be used to build up the liver's glycogen stores. Lactate is continually formed at rest and during all exercise intensities. Lactate serves as a metabolic fuel being produced and oxidatively disposed in resting and exercising muscle and other tissues. [26]
LDH-1 isozyme is normally found in the heart muscle and LDH-2 is found predominantly in blood serum. A high LDH-1 level to LDH-2 suggest MI. LDH levels are also high in tissue breakdown or hemolysis. It can mean cancer, meningitis, encephalitis, or HIV. This is usually back to normal 10–14 days. Aspartate transaminase (AST) This was the first ...