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precipitant. Clin Chem 1967;13:314-25. 2 The measurement of oxygen deficits, which is re- flected in the onset and severity of lactic acidosis, has had wide application in exercise physiology. Measure- ment of blood or plasma lactate, specifically the mea- surement of lactate/pyruvate ratios and subsequently excesslactate,becameclinicallyimportantassaysinthe 1960s after these parameters were demonstrated to be ofvalueintheevaluationandmanagementofcritically ill and injured patients. The measurements, although laborious and time-consuming, were regarded as quantitative with respect to the severity of anaerobic metabolism and therefore predictive of the prognosis of patients with major impairment in the blood circu- lation, especially during the states of low blood flow of

Forty-Five-Year Evolution of Stat Blood and Plasma Lactate Measurement to Guide Critical Care