Lactato

Dear Editor,

I read the recent publication on serum lactate with a great interest. Rocha et al. [1] noted that "After Jatene's operation, morbidity and mortality can be assessed with the serum lactate levels, suggesting increased values in the third hour is suggestive of a worse prognosis [1]." I agree that lactate measurement is useful. However, I would like to add up some concerns on lactate determination. First, the vitamin C in serum can cause a false decrease in lactate result [2]. Second, the nutritional status of the infant showed also be concerned as an important cofactor affecting the resulted lactate level [3].

Viroj Wiwanitkit, Bangcok/Tailândia

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Answer

Dear editor,

I agree with the concerns presented by professor Viroj Wiwanitkit. They are comments about potential factors that could influence serum lactate determinations, i.e. anything that influences the supply/demand of tissue oxygen. Nutritional status and serum levels of vitamin C are just some of them, among so many that we could not assess in our study.

Taís Sica da Rocha, Porto Alegre/RS


REFERENCES

1. Rocha TS, Silveira AS, Botta AM, Ricachinevsky CP, Dalle Mulle L, Nogueira A. Serum lactate as mortality and morbidity marker in infants after Jatene's operation. Rev Bras Cir Cardiovasc. 2010;25(3):350-8

2. Meng QH, Irwin WC, Fesser J, Massey KL. Interference of ascorbic acid with chemical analytes. Ann Clin Biochem. 2005;42(Pt 6):475-7.

3. Baker SS, Dwyer E, Queen P. Metabolic derangements in children requiring parenteral nutrition. JPEN J Parenter Enteral Nutr. 1986;10(3):279-81.