This is the podcast, ICU rounds.

My name is Dr. Jeffrey Guy.

I'm an associate professor of surgery and director at the Burns Center

at the Vanderbilt University School of Medicine in Nashville, Tennessee.

Welcome back.

I'm going to talk about the topic of lactic acidosis, which is something that I think is

commonly used in intensive care units and resuscitation of a post-operative patient,

a septic patient, or a trauma patient.

But I'm really an opinion that few people who are actually taking care of these patients actually

have some input or some insight as to what really is lactic

acidosis, what is it really, we measure lactate, what's it really a measure of, and how do we

use it to provide optimal resuscitation of our patients?

Lactate really is a tool that's used to measure what I would call oxygen kinetics,

and that is how well we're delivering oxygen.

You know, shock is commonly thought of by individuals as hypotension,

and hopefully through these podcasts we've demonstrated to the people that, you know,

shock is not associated to blood pressure.

Shock is really when the oxygen demand exceeds the auction delivery.

And in part, the entire organism where the person can be in shock, but particular organs can be in shock where other organs may have adequate auction delivery through to shunting or better

auto-regulation, and an organ such as kidney could be in shock because it's not getting adequate

blood flow or adequate auction delivery.

You have to think a little bit about the energetics of how tissue works, through glycolysis,

...