Clinical Use of Hypertonic Lactate-Current Evidence and Emerging Perspectives.
Level 5 - mechanism / opinion, no new human data
Narrative literature review summarizing human studies without systematic review or meta-analytic methodology
PubMed 40440417 · doi:10.1210/clinem/dgaf321
What was done
The authors conducted a literature search in PubMed and Medline using keywords related to hypertonic sodium lactate. The search was limited to human clinical studies using hypertonic sodium lactate solutions (lactate concentration ≥500 mmol/L) as an intervention. Case reports, pediatric studies, preclinical research, and psychiatric population studies were excluded.
What was found
The abstract reports that hypertonic lactate can supply up to 20% of cerebral energy metabolism. In traumatic brain injury, it increased cerebral glucose availability, lowered intracranial pressure, and enhanced cognitive recovery. In cardiac applications, it increased cardiac output, stroke volume, and ejection fraction. The infusions were generally well tolerated, with minor electrolyte shifts as the primary adverse effect. No specific numerical effect sizes, sample sizes, or confidence intervals were provided in the abstract.
Why it matters
This review highlights the emerging therapeutic role of hypertonic lactate as an active metabolic fuel and inotropic agent in acute neurology and cardiology, challenging its traditional classification merely as a metabolic waste product.
Limits
The abstract omits study counts, total patient numbers, specific effect sizes, and comparator data. As a narrative review, it lacks systematic quality appraisal, and the abstract notes that large-scale trials are still needed to optimize dosing and establish long-term safety.
Cited by
- supports Glucose metabolism and utilization in the brain are impaired following traumatic brain injury.