Not all raised lactate is sepsis or hypoperfusion! Watch this video to learn about the Lactate Map and a killer acronym to help you avoid missing the important causes of elevated lactate
Пікірлер: 93
@mrmeach19675 жыл бұрын
1:17 Electron transport and shit - love that 👍
@rumit9946 Жыл бұрын
These kinds of videos with real life examples are so much better than reading a boring text book. Thank you Cliff
@alkafi4570 Жыл бұрын
This information here should be provided to everyone who works in acute medicine. Thank you very much for your efforts. As an ICU expert, i understand the importance of this information.
@metipallearuna223 Жыл бұрын
Monitoring of Co-factor thiamine is helpful for patients before infusion of pharmaceutical lactate Crystalloidals giving negative feedback inhibition hyperventilation.
@13levels4 ай бұрын
Very very informative. Read about lactic alkalosis before and my mind was blown.
@Lulu.lulu135795 жыл бұрын
Couldn't be better than this!!!! Thank you very much .. great explination made lactate very easy finally !!!
@jz8244 Жыл бұрын
Exactly the information I was looking for. Thank you for the clear and simple lecture :))))))
@johnkodhek2 жыл бұрын
Thank you so much for this. 👏🏾👏🏾👏🏾
@Cheezyism Жыл бұрын
Brilliantly done, thank you 🙏🏻
@maphekomoloto29615 жыл бұрын
your voice is soothing to listen to , great video Dr .
@Percules13374 жыл бұрын
My man this is the best!! Definately going to throw the lactic alkalosis term around! :D
@davidmbeckmann3 жыл бұрын
Brilliant, sir, brilliant! Best discussion of lactate on KZfaq! Don't forget Warburg effect and cancer!
@jjay34944 жыл бұрын
12:21 "Woooow". Very helpful video, thanks!
@brandonbingham65075 жыл бұрын
Outstanding! Very easy to follow and practical. Thanks.
@danperlman31856 жыл бұрын
great vid.. great info! keep up the great work
@IggySalvador3 жыл бұрын
you really nailed that at the end with the "lactates" acronym
@ashmonks79266 жыл бұрын
Great Video, Thanks!
@annat22923 жыл бұрын
This is great video! Thank you for the effort :)
@mihneeea3 жыл бұрын
AMAZING!!! Thank you!
@luizaugusto1435 жыл бұрын
Great and practical ! Congratulations
@whitneyb19895 жыл бұрын
Thank you so much! I am so appreciative of your video it has completely made sense of lactate for me for Blood gas readings.
@CliffReid5 жыл бұрын
Thank you
@drearydeeds27763 жыл бұрын
@@CliffReid about to do epls so trying to understand blood gases. This is fab!!
@lordfumblewumble Жыл бұрын
This was outstanding. Thank you so much
@kmh62615 жыл бұрын
excellent presentation thank you !!
@aliyildirim6621 Жыл бұрын
Phenomenal lecture. More ICU related content pls
@RudradeepBiswas5 жыл бұрын
Thanks a lot for making this video!
@ebraheemkhaled72134 жыл бұрын
Wooooow really
@Ctpa14 жыл бұрын
An Amazing presentation!
@pranavsatish1291 Жыл бұрын
Beautifully summarised
@yohannchineegadoo64444 жыл бұрын
You are a genius, thanks for the video and the diagram and shit. just subbed.
@matthewroberts3794 жыл бұрын
love the mnemonic at the end (& the rest of it, and shit)
@metodivelkov2 жыл бұрын
Best lactate video ever
@CurlyAnji114 жыл бұрын
BRAVO!!!!!
@silviasolano37804 жыл бұрын
Wow this vid was really clear and easy to understand thank you
@mrchrisparsons92618 ай бұрын
Nice... Love a good acronym
@neetuchauhan40462 жыл бұрын
From non science background you made me understand it so beautifully. It will be great if some one can tell me how can we have enough oxygen for pyruvate to go towards PDH than Acetyl CoA. I see extreme high lactate in my OAT report
@patrickp45712 жыл бұрын
Excellent video
@mosesng11095 ай бұрын
thank you for this video.... if exercise is always done in anaerobic zone.... soon, one will becone unhealthy too
@barbadosobstaclerace11511 ай бұрын
This is how you teach!
@orenkrimchansky6 жыл бұрын
Thanks Doc!
@susanyoung81043 жыл бұрын
Thank you! Great visuals! If a patient is full of gut parasites, and/or liver flukes, would that cause LDH levels to rise?
@haleyschmidt56992 жыл бұрын
Wonderful summary. Thank you!
@ajersongargar11573 жыл бұрын
THANK YOU!!!!!
@ruwanthikulasinghe79184 ай бұрын
Thank you for the great video 😊
@sinclair657 Жыл бұрын
Thank you very much
@OBJLAB2 жыл бұрын
Nice presentation 💎
@dayo.s25124 жыл бұрын
perfect explanation. thank you
@kemifakoya27012 жыл бұрын
Thank you so much sir, I came to learn more about raise lactate after learning about a patient that was given fluid due to raise lactate, and subsequently went into fluid overload. Your explanation has made life easy. Thank you
@notadocf5382 жыл бұрын
Doctors killed my mom in the ICU ,she most likely had thiamine deficiency that caused most her problems from all the diabetic drugs causes B1 deficiency and eventually heart failure, enlarged heart etc.....doctors overload her with IV 10 different drugs: dopamine, potassium, magnesium, etc.....AND ONLY 100mg of thiamine 3 times a day. In the studies I've read it say must be doses of 1500mg a day or higher to have benefits in 4 days pacient can be discharged from hospital,also it mentioned Vitamin C as well together with thiamine IT WILL STOP THE PROGRESSION OF SEPSIS!!!!!! for all the doctors out there, if you have to break the rules of the hospitals protocol of treatments to save people's lives THEN YOU MUST DO IT!!! MY mon died because the lack of knowledge of those doctors out there.MOST OF THEM DONT READ RESEARCH and every day kill people because don't want to break rules of hospitals base treatment THAT DOESN'T WORK FOR MOST PEOPLE AND SOME DRIE BECAUSE OF THIS. IF THE BODY IS SICK THE OBVIOUS IS LACK OF CERTAIN NUTRIENTS.
@notadocf5382 жыл бұрын
Many doctors themselves don't even know what's wrong with them when they are sick, how would know to treat a patient effectively?? Them can't!
@alexandersazama57964 жыл бұрын
This is a good video. Lactate is a poor test though. Specimen collection is dicey, and the video explains its nonspecificity.
@natarajanmanickam51193 жыл бұрын
Excellent
@brightdebeauty65993 жыл бұрын
Very well explained
@fadilagomes99012 ай бұрын
Amazing video thanks alott
@mahdibaba2963 Жыл бұрын
thank you
@johnnyismybro5 жыл бұрын
Dear Dr. Read, Thanks for this excellent video. Can you make any recommendations on further key papers/reviews on lactate metabolism in ICU patients - as a supplement to your video. Thank you.
@CliffReid5 жыл бұрын
1. Marik PE, Bellomo R. Lactate clearance as a target of therapy in sepsis: A flawed paradigm. OA Critical Care. 2013;1(1). 2. Jansen TC, van Bommel J, Bakker J. Blood lactate monitoring in critically ill patients: A systematic health technology assessment*. Critical Care Medicine. 2009 Oct;37(10):2827-39.
@johnnyismybro5 жыл бұрын
@@CliffReid Thank You!
@thomasmashrick59143 ай бұрын
Could kidney failure also cause an elevated lactate due to the kidneys inability to excrete the lactate? Great video, thank you!
@melinazzanabria73802 жыл бұрын
Hi, thanks for the video. I thought that when you hyperventilate your CO2 levels drop?? as your lungs exhale co2?
@Arunnath0k3 жыл бұрын
Thanks 👍
@honorburza9110 Жыл бұрын
Great video thank you. How long can the elevated lactate go on for if it was due to salbutamol please? If the salbutamol use has stopped. Could it last months (tingling in fingers on outbreath for example)?
@CliffReid10 ай бұрын
No it clears the same day - minutes to hours
@benikramer51153 жыл бұрын
Thiamin and magnesium deficiency can manifest in korsakoff-psychosis and high lactate
@jibbyjabs11 ай бұрын
Important to note that in inborn errors of metabolism, the treatment is often glucose infusion.. this causes elevated lactate, and in this case it is just the response to treatment.
@cu99460 Жыл бұрын
Can you explain elevated levels of lactate in ARDS please?
@ccamire3 жыл бұрын
What happens if you use fat for energy and your glucose is at a minimum
@account-qn8sc9 ай бұрын
My lactate level is 2.95, is it dangerous?
@brendasester8 ай бұрын
Mine was not a real concern , slightly elevated, it when it up after my steroid injection
@mahanteshgouri29312 жыл бұрын
Hi sir I am from India my son is 2 and half years suffering from elivated lactate acid ( IEM) by birth how is life my son pls tell me sir
@mrmeach19674 жыл бұрын
5:43 Thiamine deficiency. Really thiamine pyrophosphate (TPP), the active form.
@ChristianChase74 жыл бұрын
mrmeach1967 check this out! “Magnesium plays an important role in oxidative metabolism. The conversion of thiamine to its active triphosphate form is reliant on magnesium as a cofactor.9-11 Thiamine pyrophosphate, in conjunction with pyruvate dehydrogenase, is critical in the metabolism of pyruvate to acetyl coenzyme A for entrance into the citric acid cycle.12 In the absence of magnesium, disrupted oxidative phosphorylation shifts toward anaerobic metabolism, resulting in lactic acid production.” www.ncbi.nlm.nih.gov/pmc/articles/PMC4909152/
@pangea95965 жыл бұрын
A lactate of 2.7 is worrisome? 5 months ago 1.5 mmol lactate,
@account-qn8sc9 ай бұрын
Mine is 2.95(((
@Yippeekiyaymummy3 жыл бұрын
Can high lactic acid levels cause brain fog and affect memory?
@Yo-yo-dt5ze8 ай бұрын
Yes I had brain fog and memory problems when I was septic in 2022
@EdithIvhay3 жыл бұрын
So basically you f you don’t eat sugar before or after a workout you won’t have a response from pyruvate? No pain? I think this is true because when I eat keto and workout no pain. But it’s f I eat a carbohydrate rich meal after. Workout there is pain.
@CPeyser08 Жыл бұрын
This was super helpful! Thanks!
@charmkang61202 жыл бұрын
lactic.. akalosis??? dang... thank you
@gsuguna134 жыл бұрын
My son 3.5months old he have Lactate plasma issue 10.7 . Now he is not able to speak🗣 and he is not identifying if say anything he is not able to understand. My docter said it is genetic problem come from mother she said it is not curable. Please suggest it is curable? What steps we need to take to improve my baby
@CliffReid4 жыл бұрын
I'm so sorry that isn't my area of expertise. I wish your family well.
@orenkrimchansky6 жыл бұрын
Doc, what about diabetes? . Can it simulate the increase of gluconeogenesis and create exuberant lactate concentration ?
@CliffReid6 жыл бұрын
Haven't seen much raised lactate in diabetes without one of the other causes. Found this paper: pamw.pl/sites/default/files/PAMW_2013-3_Krzymien.pdf
@orenkrimchansky6 жыл бұрын
Cliff Reid thanks Doc. Cheers from italy. Your. Video is illuminating
@kdcruz755 жыл бұрын
Isnt one of the side effects of metphormin... Muscle pain... Does the buildup of lactate due to inhibition of gluconeogenesis cause this...
@richardshepherd1216 Жыл бұрын
Things have moved on since the pyruvate goes to Acetyl CoA under aerobic circumstances and to lactate in anaerobic conditions hypothesis. There is no oxygen demand for either pathway and no way for oxygen to switch metabolism from one to the other. All pyruvate is now thought to be converted to lactate in the cytosol. This shuttles between cells as needed for energy transfer (see lactate shuttle theory). Lactate that enters the mitochondrial intramembrane space is converted back to pyruvate and then on to Acetyl CoA. Elevated lactate does not signify ischaemia or hypoxia, it signifies a "stressed" metabolism with glycolytic production of lactate exceeding intracellular clearance. If lactate somehow was linked to hypoxia then it would rise under hypoxic conditions and conversely one would find hypoxia where there is high lactate. The former is not seen in Everest submitters who had normal lactates despite SpO2 of as low as 30% and the latter is not seen intracellularly in volunteer athlete's thigh muscles after exercise to failure.