- Can be metabolised via two mechanisms:
- Oxidation to water and CO2 (70% in health)
- Gluconeogenesis (30% in health)
- Both mechanisms consume a Hydrogen ion (H+) and thus have an alkalinising effect
- Mechanisms can be used to clear acid in critical illness:
- Infusion of exogenous buffered lactate solution (e.g. Hartmann’s) provides lactate anions for the liver
- Results in net consumption of hydrogen ions, at rates up to 100mmol/h
