Table 1 The characteristics of different components in fluid therapy

Lactate

The end-product in the glycolysis pathway

Alleviating LA in moderate HS [28] through plasma expansion

Not working in severe HS and aggravating glycolysis inhibition and lactate accumulation [31,32,33]

Acetate

Metabolized to acetyl-CoA which is later used in the TCA cycle

Alkalizing plasma quickly, not inhibiting glycolysis and not elevating lactate concentration [40]

Side effect of impaired cardiac contractile response [41], inhibiting PDH activity [42]

Malate

The key intermediate in the TCA cycle

Working in cases of moderate acidosis [44] and moderate HS [46] and elevating energy production [45]

May not be suitable for the LA under severe hypoxic conditions

Pyruvate

The key intermediate in the glycolysis pathway and the TCA cycle

Correcting LA in moderate and lethal HS animals [47,48,49, 52, 53], isolated failing human myocardium [57] and ischemia-reperfusion injury model [51]

Not approved in clinic