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Lactate anion (CH3CH(OH)COO-) serves the important purpose of providing ''raw material'' for subsequent regeneration of bicarbonate (HCO3-) and thus acts as a source (alternate) of bicarbonate when normal production and utilization of lactic acid is not impaired as a result of disordered lactate metabolism. Lac-tate anion is usually present in extracellular fluid at a level of less than 1 mEq/L, but may attain a level of 10 mEq/L during exercise. It is seldom measured as such and thus is one of the''unmeasured anions'' (''anion gap'') in determinations of the ionic composition of plasma.
Since metabolic conversion of lactate to bicarbonate is dependent on the integrity of cellular oxidative processes, lactate may be inadequate or ineffective as a source of bicarbonate in patients suffering from acidosis associated with shock or other disorders involving reduced perfusion of body tissues. When oxidative activity is intact, one to two hours time is required for conversion of lactate to bicarbonate.
The lactate anion is in equilibrium with pyruvate and has an alkalizing effect resulting from simultaneous removal by the liver of lactate and hydrogen ions. In the liver, lactate is metabolized to glycogen which is ultimately converted to carbon dioxide and water by oxidative metabolism.
The sodium (Na+) ion combines with bicarbonate ion produced from carbon dioxide of the body and thus retains bicarbonate to combat metabolic acidosis (bicarbonate deficiency). The normal plasma level of lactate ranges from 0.9 to 1.9 mEq/L.
Sodium is the principal cation of extracellular fluid. It comprises more than 90% of total cations at its normal plasma concentration of approximately 140 mEq/L. The sodium ion exerts a primary role in controlling total body water and its distribution.
Last reviewed on RxList: 1/16/2009
This monograph has been modified to include the generic and brand name in many instances.
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