Exercise physiology and pathophysiology of lactate acidosis and clearence

Abstract

Lactic acid is a naturally occurring molecule with original detection
falling into a category of lactic acid-producing bacterial organisms.
However first detected in foods, its increased concentration in
muscles of hunted animals was later linked with lactate acidosis
origin. Physiologically, high rate of ATP hydrolysis, occurring during
anaerobic glycolysis, contributes to the formation of lactate acidosis.
Not only skeletal muscles, despite of their large mass, but also brain,
liver, kidney and adipose tissue function as consumers of lactate.
Elevated metabolic rate during physical work promotes lactate
clearance via accelerated rate of its oxidation. Strong evidence about
the effects of certain diseases on lactate metabolism exists. In
pathophysiology, elevated concentration of lactate in blood may be
caused by its increased production, decreased clearance, or a
combination of both. Abnormally increased blood lactate levels occur
during hypoperfusion/hypoxemia or dysfunction of cellular
metabolism. The rising body of literature demonstrating that the initial
level and/or the rate of blood lactate clearance predicts the mortality
following trauma, severe sepsis or cardiac surgery has accumulated.