🩸 Lactate Clearance
Lactate clearance is the percent fall between two serial lactate measurements, a marker of resuscitation adequacy and prognosis in sepsis and shock.
Lactate Clearance
Initial lactate (mmol/L)
Repeat lactate (mmol/L)
When to use
Enter the initial and repeat lactate; the tool returns percent clearance. A clearance ≥ 10% (or normalization) over the resuscitation window is a common favorable target.
How it works
Clearance (%) = (initial lactate − repeat lactate) / initial lactate × 100. Targets often cited: ≥ 10% over 2 hours, or normalization to < 2 mmol/L.
Key points
- Lactate-guided resuscitation targeting clearance has been associated with lower mortality, but clearance is an adjunct to clinical perfusion endpoints, not a stand-alone goal. (original synthesis · not guideline verbatim)
- A negative clearance (rising lactate) is a red flag for ongoing or worsening hypoperfusion.
- Non-hypoperfusion causes — hepatic dysfunction, metformin, β-agonists, seizures — can elevate or slow the fall of lactate and confound interpretation.
References
- Jones AE, et al. Lactate clearance vs central venous oxygen saturation as goals of early sepsis therapy. JAMA. 2010;303(8):739-746.
- Evans L, et al. Surviving Sepsis Campaign: International Guidelines 2021. Crit Care Med. 2021;49(11):e1063-e1143.
Decision support for licensed clinicians only; not a substitute for clinical judgement, diagnosis or local protocols.