Lactate as a Risk Marker in Emergency and Intensive Care Medicine
A lactate increase under physiological conditions is an expression of the adaptation of the organism to situations in which so much oxygen is consumed that aerobic metabolic pathways for the generation of adenosine triphosphate for the cell metabolism are not sufficiently available. Normally, these situations are transient, lactate formation is adaptive and lactate degradation in the healthy organism is undisturbed, so that in a healthy organism lactate elevations are rapidly reversible after the end of the stress situation.
In the case of a sick person, a prolonged increase in lactate levels is always to be seen as a sign of a serious illness and a serious prognostic factor for increased mortality. Causes may be in addition to an increased lactate formation and a disturbed lactate degradation. In many threatening illness situations - such as sepsis and shock events of other causes - a combination of both factors is present.
The online seminar highlights the causes and consequences of hyperlactatemia and lactic acidosis, introduces diagnostic algorithms and discusses the role of lactate determination in controlling the course of therapy. Also a case in which a lactate elevation was the only marker of an unexpected diagnosis is presented.
Prof. Dr. med. med. Christoph Dodt, Head Physician Emergency Center, Municipal Hospital Munich Bogenhausen
Professor Dodt has been chief physician at the emergency center of the Städtische Klinikum München Bogenhausen for more than 10 years.Previously, he was a senior consultant for the intensive care unit and the emergency room at the University Hospital Schleswig Holstein Campus Lübeck, where he habilitated for the subject of internal medicine and held a professorship for "internistic intensive care" until 2007.
For 6 years he has been President of the German Society for Interdisciplinary Emergency and Acute Medicine and member of the board of the European Society of Emergency Medicine. In addition to his clinical work, he has advised numerous hospitals in the setting up of emergency departments, he is frequently requested as an expert in expert reports and legal proceedings and has supervised and published numerous scientific papers.
He is a member of the editorial boards of the journals "Emergency and Rescue Medicine" and "Medical Clinic - Intensive Care and Emergency Medicine".