الفهرس 
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Abstract
In healthy individuals, there is a continuous cycle of lactate production and metabolism, which ensures that blood lactate concentrations are normally low. Elevated blood lactate occurs when its production exceeds its clearance, or when clearance capacity is decreased or more frequently when both occur simultaneously. Hyperlactemia is associated with increased hospital mortality in the critically ill patients. Thus, adoption of lactate measurement in most blood gas analyzers in the critically ill patients was performed.
Measurement of blood lactate concentrations gives an indication of the adequacy of oxygen delivery to tissues in neonates. Lactate accumulates in tissues, blood and CSF as a result of anaerobic metabolism. Thus, measurement of blood or plasma lactate concentrations gives an indication of the adequacy of current oxygen delivery to tissues which may be reduced during hypoxemia, cardiac failure, or peripheral vascular shutdown. This may alert clinician to problems with oxygen delivery to the tissues for example in neonatal septicemia or persistent ductus arterious. High plasma lactate concentrations have been associated with adverse out come after perinatal hypoxia is ischemia and in neonates undergoing extracorporeal membrane oxygenation.
Adverse outcome is defined as death within the first week of life or evidence of periventricular leukomalacia. It also includes severe intraventricular hemorrhage ”IVH” (grade 3 or 4 IVH detected by cranial U/S), which is common in preterms, low and extremely low birth weight (ELBW).