Answer :
Patients who have experienced trauma usually develop hypovolemic shock, which determines different levels of tissue hypoperfusion. The determination of lactate level has been used as a reliable biomarker in the assessment of the magnitude of hypoperfusion.
The metabolic response to trauma culminates in an inadequate supply of oxygen, hypoxia, and anaerobic metabolism, the final product being lactate. It results from the metabolism of pyruvate catalyzed by the enzyme lactate dehydrogenase, discovered in high concentrations in shock patients 2 5 10.
We found that at a cutoff factor of 2.0 mmol/l, serum lactate assays were useful in discriminating between the severely and non-severely injured trauma patients with a sensitivity of 88%. It was predictive of mortality outcomes and of who would be discharged at lactate levels of four mmol.
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