Welcome to The Pearl Log — where post-shift wisdom surfaces, one shiny clinical take at a time. Some pearls are fresh, some are rough, all are found under pressure.
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Lactate, Lactate, Lactate…
Lactate has two personalities, and not all of them mean “shock.”
Type A stems from true hypoperfusion and anaerobic metabolism, while Type B comes from impaired lactate clearance or altered cellular processing—think thiamine deficiency, ethanol, metformin, malignancy, or liver disease. And when it spikes after a seizure? It’s only meaningful if caught fast—within about 90 minutes—before it clears and the trail goes cold.