Effects of sodium L-lactate and sodium racemic lactate on intraoperative acid-base status.
Level 3 - non-randomized controlled study
Controlled clinical trial without explicit mention of randomization in the abstract
PubMed 1416121 · doi:10.1213/00000539-199211000-00008
What was done
Patients undergoing tympanoplasty under general anesthesia received infusions of Ringer's solution containing either no lactate, sodium L-lactate (84 mEq/L), or racemic DL-lactate (84 mEq/L, three times the standard concentration). Investigators evaluated blood concentrations of L-lactate, D-lactate, the L-lactate/pyruvate ratio, bicarbonate ion concentration, base excess, and overall buffering capacity across the three groups.
What was found
The abstract reports no numerical values. Blood levels of L-lactate, D-lactate, and the L-lactate/pyruvate ratio differed across all three groups. No differences were observed between the L-lactate and racemic lactate groups in post-infusion bicarbonate concentration or base excess. Both lactate groups achieved significant increases in buffering capacity compared to preinfusion levels and compared to the nonlactated Ringer's control group.
Why it matters
These results indicate that racemic DL-lactate is metabolized at a rate comparable to pure L-lactate in generating buffer base, supporting the clinical utility of standard racemic lactated Ringer's formulations for acid-base management.
Limits
The abstract provides no sample size, patient baseline characteristics, or exact quantitative data and variance measures. It does not state whether treatment allocation was randomized or blinded. The findings reflect a single elective surgical setting using high-dose lactate solutions (84 mEq/L) and may not generalize to patients with critical illness or impaired hepatic clearance.
Cited by
- supports Lactated Ringer's solution was historically prepared as a 50/50 racemic mixture of D-lactate and L-lactate.