MultisystemDifficulty 2/5
A patient with suspected sepsis has a normal blood pressure but a lactate of 4.2 mmol/L. How should this be interpreted?
- AThe patient requires immediate intubation regardless of respiratory status
- BPerfusion is adequate because the blood pressure remains within normal limits
- CTissue hypoperfusion is present despite the normal blood pressure
- DThe lactate is unrelated to perfusion and should be repeated in 24 hours
Show answer and rationale
Correct: C. An elevated lactate indicates tissue hypoperfusion or metabolic stress even when the blood pressure is preserved — so-called cryptic shock. Normal pressure does not exclude inadequate perfusion.
- B — Blood pressure is a late and insensitive marker of perfusion.
- D — Delaying 24 hours ignores a marker of active hypoperfusion.
- A — Nothing in the scenario indicates airway failure.