ICMの1月号に、乳酸クリアランスについての文章が3つ載っていた。
それぞれの（ほぼ）最後の文章をコピペしてみた。
Masyuk M, Wernly B, Lichtenauer M, et al.
Prognostic relevance of serum lactate kinetics in critically ill patients.
Intensive Care Med. 2019 Jan;45(1):55-61. PMID: 30478622.
"ΔLac was robustly associated with short- and long-term mortality in our study cohort of critically ill patients, constituting a quick and easy risk stratification parameter. "
Geri G, Hernandez G, Vieillard-Baron A.
Lactate kinetics in critically ill: a new prognostic marker or just another brick in the wall?
Intensive Care Med. 2019 Jan;45(1):113-114. PMID: 30569294.
"...could be integrated in future studies that will evaluate the clinical effectiveness of lactate-guided resuscitation protocols."
Hernandez G, Bellomo R, Bakker J.
The ten pitfalls of lactate clearance in sepsis.
Intensive Care Med. 2018 May 12. [Epub ahead of print] PMID: 29754310.
"... the idea of seeking to lower lactate by increasing its “clearance” in sepsis is both an illusion and a folly."
それぞれちょっとずつニュアンスが違って、ちょっと面白い。
乳酸クリアランスはマーカーなのか、治療の指標なのか、それとも幻影なのか？
