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If lactate is significantly elevated, it may be ordered at intervals to monitor the condition. CSF and blood lactate levels may be ordered when a person has signs and symptoms of meningitis, such as severe headaches, fever, delirium, and loss of consciousness.
(2) Elevated lactate in septic shock is mostly due to stimulation of beta-2 adrenergic receptors. Lactate elevation in sepsis seems to be due to endogenous epinephrine stimulating beta-2 receptors (figure below). Particularly in skeletal muscle cells, this stimulation up-regulates glycolysis, generating more pyruvate than can be used by the cell's mitochondria via the TCA cycle.