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The following is a summary of “Cardiovascular effects of lactate in healthy adults,” published in the January 2025 issue of Critical Care by Berg-Hansen et al. 

Low-volume hypertonic solutions, including half-molar lactate (LAC), have emerged as potential alternatives for fluid resuscitation.  

Researchers conducted a retrospective study to investigate the cardiovascular effects and mechanisms of LAC infusion compared to sodium-matched hypertonic sodium chloride (SAL).  

They randomized 8 healthy male participants with each receiving a 4-hour infusion of LAC and SAL in random order. Echocardiography and blood samples were conducted with assessors blinded to the treatment. The primary outcome was cardiac output (CO) assessed through echocardiography.  

The results showed that during LAC infusion, circulating lactate levels increased by 1.9 mmol/L (95% CI 1.8–2.0 mmol/L, P < 0.001) compared to SAL, CO rose by 1.0 L/min (95% CI 0.5–1.4 L/min, P < 0.001), mainly due to an 11 mL increase in stroke volume (95% CI 4–17 mL, P = 0.002), with no change in heart rate. Left ventricular ejection fraction improved by 5 percentage points (P < 0.001), and global longitudinal strain increased by 1.5 percentage points (P < 0.001). Preload indicators were higher during SAL infusion compared to LAC. Additionally, afterload parameters, including systemic vascular resistance and effective arterial elastance, were reduced with LAC, while mean arterial pressure remained unchanged. Contractility indicators improved during LAC infusion.  

Investigators concluded the LAC infusion showed superior cardiac function compared to saline, evidenced by enhanced contractility, decreased afterload, and maintained preload, suggesting its potential as a beneficial fluid in patients with cardiac dysfunction. 

Source: ccforum.biomedcentral.com/articles/10.1186/s13054-025-05259-0