Capillary refill is as least as good as measuring lactate in guiding resuscitation efforts in septic shock. Moreover, using a lactate-driven resuscitation strategy led to use of more pressors and more IV fluid administration without any change in all-cause mortality. Patients, aged ≥ 18 yrs with septic shock admitted to the ICU. Septic shock was defined as suspected or confirmed infection plus hyperlactinemia ≥ 2 and requiring vasopressors to maintain MAP > 65 after a fluid bolus of 20 cc/kg over min.

Hyperlactinemia is one marker of hypoperfusion among many that the Surviving Sepsis Campaign has proposed to guide hemodynamic resuscitation. Yet hyperlactinemia is not only present in shock states, and efforts to measure lactate may not be readily available in all health care settings.

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