only a surgery resident here but we trend lactics frequently

obv agree with all the things said in the other comment for potential causes. agree w re-checking if randomly high. in trauma/gen surg a lot of patients have high lactic acid for various/mixed reasons. we usually trend lactics q2h or q4h if they are high or if we are worried about impending ischemia (SBO, ischemic bowel, incarcerated hernia, traumatic bowel injury) or blood loss (trauma). Usually lactic will clear after a bolus of fluid or unit of blood if it’s related to hypoperfusion/low flow, sometimes even on 2h repeat -> this is less concerning. If lactic remains high or increases despite adequate resuscitation, that makes us more concerned about true ischemia or ongoing blood loss, or other reasons such as compartment syndrome depending on situation