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L-lactate provision in preterm newborns: friend or foe?

Pediatric Research volume 98, pages 376–378 (2025)Cite this article

AbstractSection Abstract

Preterm newborns are at risk for metabolic abnormalities due to immature cellular pathways, oxidative stress, and extrauterine adaptation. Lactate, historically considered a metabolic byproduct, plays a crucial role in energy metabolism, mitochondrial function, and neuroprotection. Ibrahim et al. proposes the use of sodium L-lactate (NaL) as an alternative to sodium chloride-based fluids in preterm newborns. Evidence suggests that lactate metabolism influences transcription factors, mitochondrial biogenesis, and neuronal energy utilization. However, questions remain regarding its safety, dosing, and long-term effects, particularly in neonates with brain asphyxia. Further studies are needed to evaluate NaL’s potential benefits in neonatal care.

AbstractSection Impact

  • L-lactate is important for energy production, especially in the brain.

  • Ibrahim et al. propose the use of sodium L-lactate as an alternative maintenance fluid in preterm newborns.

  • L-lactate cannot be considered only as a simple fluid replenishment.

  • L-lactate via its metabolism influences transcription factors, mitochondrial biogenesis, and neuronal energy utilization.

  • Further studies are needed to evaluate sodium L-lactate potential benefits and possible side effects in newborns.

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References

  1. Omar Ibrahim, I. et al. Positive impact of Sodium L-Lactate supplementation on blood acid-base status in preterm newborns. Pediatr Res. https://doi.org/10.1038/s41390-025-03963-9 (2025).

  2. Brooks, G. A. Cell-cell and intracellular lactate shuttles. J. Physiol. 587, 5591–5600 (2009).

    Article  PubMed  PubMed Central  CAS  Google Scholar 

  3. Laughlin, M. R., Taylor, J., Chesnick, A. S., DeGroot, M. & Balaban, R. S. Pyruvate and lactate metabolism in the in vivo dog heart. Am. J. Physiol. 264, H2068–H2079 (1993).

    PubMed  CAS  Google Scholar 

  4. Pellerin, L. & Magistretti, P. J. Glutamate uptake into astrocytes stimulates aerobic glycolysis: a mechanism coupling neuronal activity to glucose utilization. Proc. Natl. Acad. Sci. USA 91, 10625–10629 (1994).

    Article  PubMed  PubMed Central  CAS  Google Scholar 

  5. Dienel, G. A. Lactate shuttling and lactate use as fuel after traumatic brain injury: metabolic considerations. J. Cereb. Blood Flow. Metab. 34, 1736–1748 (2014).

    Article  PubMed  PubMed Central  CAS  Google Scholar 

  6. Vannucci, R. C., Yager, J. Y. & Vannucci, S. J. Cerebral glucose and energy utilization during the evolution of hypoxic-ischemic brain damage in the immature rat. J. Cereb. Blood Flow. Metab. 14, 279–288 (1994).

    Article  PubMed  CAS  Google Scholar 

  7. Izumi, Y., Benz, A. M., Zorumski, C. F. & Olney, J. W. Effects of lactate and pyruvate on glucose deprivation in rat hippocampal slices. Neuroreport 5, 617–620 (1994).

    Article  PubMed  CAS  Google Scholar 

  8. Powell, C. L., Hernandez, M. J. & Vannucci, R. C. The effect of Lactacidemia on regional cerebral blood flow in the newborn dog. Brain Res 349, 314–316 (1985).

    Article  PubMed  CAS  Google Scholar 

  9. Roithmaier, A. et al. Randomized controlled trial of ringer solution versus serum for partial exchange transfusion in neonatal Polycythaemia. Eur. J. Pediatr. 154, 53–56 (1995).

    Article  PubMed  CAS  Google Scholar 

  10. Datta, P. K. et al. Dextrose-containing intraoperative fluid in neonates: a randomized controlled trial. Paediatr. Anaesth. 26, 599–607 (2016).

    Article  PubMed  Google Scholar 

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Acknowledgements

We would like to acknowledge the Crystal Charity Ball and the NeuroNICU program at the University of Texas Southwestern Medical Center for supporting this project.

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Authors and Affiliations

  1. Division of Neonatal-Perinatal Medicine, Department of Pediatrics, University of Texas Southwestern Medical Center, Dallas, TX, USA

    D. Angelis, LP Brion & L. Chalak

  2. Children’s Health, Dallas, TX, USA

    D. Angelis, LP Brion & L. Chalak

Authors
  1. D. Angelis
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  2. LP Brion
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  3. L. Chalak
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Contributions

D.A. wrote the first draft of the manuscript. D.A., L.P.B. and L.C. critically revised the manuscript and approved the final manuscript for submission.

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Correspondence to D. Angelis.

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Angelis, D., Brion, L. & Chalak, L. L-lactate provision in preterm newborns: friend or foe?. Pediatr Res 98, 376–378 (2025). https://doi.org/10.1038/s41390-025-04104-y

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