Lactic Acidosis

Lactic acidosis is elevated serum lactate (>5 mmol/L) with metabolic acidosis. Type A: tissue hypoxia/hypoperfusion (shock, sepsis, cardiac arrest, severe hypoxia). Type B: impaired lactate metabolism without overt hypoxia (sepsis, metformin-associated, liver failure, malignancy, thiamine deficiency). It is a marker of high mortality. Treatment: restore tissue perfusion (fluids/pressors), treat sepsis/cardiac cause, discontinue offending drugs, and supportive care; bicarbonate only in severe acidemia.

Common Symptoms

Tachypnea; hypotension; confusion; abdominal pain; shock; cold clammy skin; elevated lactate

Causes and Pathogenesis

Anaerobic glycolysis from tissue hypoxia (type A) or impaired hepatic/renal lactate clearance (type B) causes lactate accumulation and metabolic acidosis.

Treatment

Restore perfusion (fluids/pressors); treat sepsis/cardiac cause; discontinue metformin; thiamine; supportive; bicarbonate in severe

Preventive Measures

Early sepsis recognition; caution metformin in renal failure/liver hypoxia; monitor lactate.

Department to Visit

It is recommended to visit the Emergency department; an appointment can be booked on this platform before the visit.

Warm reminder: The above information is for health science reference only and cannot replace professional medical diagnosis. If you have related symptoms, please seek medical attention at a regular hospital promptly.