ReviewCritical care (London, England)2014
Sepsis-associated hyperlactatemia.
Review in Critical care (London, England), 2014. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to 3 registered trials, which are not on this map. Cited by 247 papers.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Early Goal Directed Therapy Using a Physiological Holistic View. A Multicenter Study in Latin America: The ANDROMEDA-SHOCK Study
Peripheral Perfusion Versus Lactate Targeted Fluid Resuscitation in Septic Shock: ANDROMEDA-SHOCK PHYSIOLOGY STUDY
The Effect of Extracorporeal Sepsis Adsorption Column Use on Plasma Syndecan-1 Level and Mortality in Sepsis Patients
Who cites it
247 citing papers in PubMed, 474 citations in OpenAlex.
- Trial
- Type B Lactic Acidosis: Diagnosis, Etiology and Treatment - An Educational Review.Cardiology research · 2026Review
- The carotid body in sepsis: From homeostatic defense to immunometabolic dysregulation.Brain, behavior, & immunity - health · 2026Review
- Illustrating the functional heterogeneity of M-MDSCs to predict sepsis outcomes.Journal of advanced research · 2026Article
- Early Immune Phenotype-Guided Immunomodulatory Strategies and Intensive Care Outcomes in Septic Shock: A Single-Center Retrospective Cohort Study.Shock (Augusta, Ga.) · 2026Observational
- Day-7 lactate-to-albumin ratio as a prognostic marker in sepsis patients requiring prolonged mechanical ventilation: a multicenter retrospective landmark analysis of the Korean Sepsis Alliance registry.Journal of thoracic disease · 2026Article
- Hour-1 Sepsis Bundle: Updated Evidence.Journal of clinical medicine · 2026Review
- Combined metabolic risk and admission lactate-to-bicarbonate ratio in critically ill children: a retrospective pediatric ıntensive care cohort study.European journal of pediatrics · 2026Article
- Twenty-five years of septic shock hemodynamic resuscitation trials: a conceptual perspective.Critical care (London, England) · 2026Review
- Perioperative Point-of-Care Ultrasound Utilization in Abdominal Organ Transplantation. Part II: Postoperative Care.Clinical transplantation · 2026Review
- Lactate to albumin ratio and 30-day mortality in ICU patients with influenza: a single-center retrospective cohort.Virology journal · 2026Observational
- Sepsis prognosis in the emergency department: assessment of shock indices, SOFA, qSOFA, and lactate.International journal of emergency medicine · 2026Article
- Tetrahedral DNA Nanostructure-Based Biomimetic Nanovesicles Attenuate Sepsis-Associated ARDS by Suppressing Glycolysis via the BMAL1/PFKFB3 Axis.Advanced science (Weinheim, Baden-Wurttemberg, Germany) · 2026Article
- High vasopressor doses are associated with decreased tissue oxygenation in critically ill patients: a secondary analysis of a prospective cohort.Critical care (London, England) · 2026Article
- Phenotype discovery and mortality prediction in sepsis-induced myocardial dysfunction: a deep learning and stratified modeling approach.BMC medical informatics and decision making · 2026Article
- The relationship between lactate-to-albumin ratio and prognosis in patients with sepsis-induced cardiomyopathy: a retrospective cohort study.Scientific reports · 2026Article
- Lactate abnormalities during intravenous linezolid therapy in hospitalized children: a brief report.European journal of pediatrics · 2026Article
- Molecular vehicles for therapeutic delivery of lactate in exercise and medicine.Sports medicine and health science · 2026Review
- Article
- Pediatric Sepsis: Evolving Subphenotypes, Overlap Syndromes, and the Path to Precision Therapies.Clinics in chest medicine · 2026Review
187 more citing papers are in PubMed but not listed here.
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
3 authors at 3 institutions in 3 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
There is overwhelming evidence that sepsis and septic shock are associated with hyperlactatemia (sepsis-associated hyperlactatemia (SAHL)). SAHL is a strong independent predictor of mortality and its presence and progression are widely appreciated by clinicians to define a very high-risk population. Until recently, the dominant paradigm has been that SAHL is a marker of tissue hypoxia. Accordingly, SAHL has been interpreted to indicate the presence of an 'oxygen debt' or 'hypoperfusion', which leads to increased lactate generation via anaerobic glycolysis. In light of such interpretation of the meaning of SAHL, maneuvers to increase oxygen delivery have been proposed as its treatment. Moreover, lactate levels have been proposed as a method to evaluate the adequacy of resuscitation and the nature of the response to the initial treatment for sepsis. However, a large body of evidence has accumulated that strongly challenges such notions. Much evidence now supports the view that SAHL is not due only to tissue hypoxia or anaerobic glycolysis. Experimental and human studies all consistently support the view that SAHL is more logically explained by increased aerobic glycolysis secondary to activation of the stress response (adrenergic stimulation). More importantly, new evidence suggests that SAHL may actually serve to facilitate bioenergetic efficiency through an increase in lactate oxidation. In this sense, the characteristics of lactate production best fit the notion of an adaptive survival response that grows in intensity as disease severity increases. Clinicians need to be aware of these developments in our understanding of SAHL in order to approach patient management according to biological principles and to interpret lactate concentrations during sepsis resuscitation according to current best knowledge.
Indexed as
Identifiers
What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.