Lactate-Pyruvate Studies in Ischemic Feet

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Abstract
It has been stated previously that the ratio of lactate concentration to pyruvate concentration in femoral venous blood reaches higher levels during exercise in patients with arteriosclerotic legs than in normal subjects, indicating an increased shift toward anaerobic metabolism. Ischemia of the foot was studied in chronic arterial occlusion by obtaining venous blood from the dorsum of the foot. The blood flow capacity to the toes was less than 10% of normal in the 6 patients studied. Venous blood from the patients'' hands and from the hands and feet of 6 normal, vasodilated subjects was used as controls. In the ischemic feet, the lactate-pyruvate ratio averaged 8:1 (6:1 to 11:1), the lactate, 13.7 (8.4 to 19.5) mg.% and pyruvate, 1.7 (1.3 to 2.5) mg.%. There was no essential difference between these results and the control values. Thus, despite severe deprivation of blood flow, no evidence was found of increased anaerobic metabolism in ischemic feet at rest.