Lactate analyzer measure lactate , NIRS devices measure SmO2 and tHb trends.
I like to show you an email I got to look for a possible answer in the use of lactate in specific cases.
Than I lie to throw the question out on how MOXY would react in this case. Including the question, why lactate actually may indicate the problem .
The question I got.
Can cyanide poisoning show up when using lactate as a possible marker to the problem
Some very short info to this case.
As we now by know lactate production due to hypoxia is rather the exception than the rule ( Roberge) lactate is always produce and there. Only when the production or the utilization of O2 is out of balance do we see an increase or decrease if a certain amounts circulating in the system.
This was a fundamental part of our own LBP idea when we looked for lactate trends and possible metabolic balance.
So here what is interesting
When we are active and demand O2 as the primary energy source, the hemoglobin tetramer undergoes subtle intramolecular conformational changes called cooperativity.
The result of this cooperativity, after the first oxygen has been unloaded, than the unloading of the second oxygen is much easier (facilitated). This means that the second oxygen can dissociate after a much smaller change in oxygen pressure than was needed to unload the initial first one. Another conformational change facilitates dissociation of the third oxygen.
So you can see that the Cooperativity is an important phenomenon that permits the loading and unloading of large amounts of oxygen at physiologically relevant oxygen pressures.
Now certain Chemicals can interfere with oxygen transport and/or cooperativity and than will be therefor very harmful to lethal. Before the complete disaster lactate and possible NIRS could give some warning feedback and possibly time to avoid the deadly reaction. Here why lactate could be a warning feedback lie it is in sepsis.
In general we learn.
Oxygen lack is known as hypoxia; the complete absence of oxygen is called anoxia.
Andri just sent a nice internal group memo out on the discussion and definition of the different O2 reactions. He may share this on here more to a bigger audience.
for the moment very short here the four basic types we could see in hypoxia in our case.
1. Stagnant or hypokinetic hypoxia
2. Arterial or anoxic hypoxia
3. hypoxia as it is know as anemic hypoxia
And now last but not least our case email question
Now as you will see due to the specificity of the reaction some immediate will argue that this is not a real HYPOXIA.
Because both the arterial oxygen tension and the oxygen content of blood are normal.
The lesion here is caused by poisons such as cyanide or hydrogen sulfide, which block the utilization of oxygen at the cellular level.
We name this bio availability of O2. Remember we can create this as well during a physiological training with some specific intervention so we can go hypoxic in a very low intensity like during walking or 100 watt cycling or slow stepper or very slow rowing or in individual muscle group workouts.
Now look the problem when we use the blood values which would b consider incredible accurate. They do not show a problem with O2.
So as we do not are able to use O2 we will see a delayed but reaction in lactate values like we see in sepsis ( different reason or mechanism there)
BUT now think carefully how MOXY may give us as well a hint in the O2 problem. and why a combination sometimes is needed to have better answer.
So short answer.
Yes lactate can or could give a hint of Cyanide poisoning or trend of the substance in the body.
Any other comment is appreciated