Lactic acidosis

Causes

Appropriate Tests

 

Blood gas arterial; L-Lactate, Electrolytes, Urea, Creatinine; Hydroxybutyrate if ketoacidosis also suspected; Urate.

Shock, including

  • Sepsis
  • Hypovolaemia



See Septicaemia

Asphyxia, including

  • Grand mal fits

 

Heart failure (severe)

See Cardiac failure

Drug toxicity, including

 

  • Metformin toxicity

 

  • Salicylate toxicity

Salicylate. See Drug assays - therapeutic drug monitoring.

  • Ethanol toxicity

Ethanol level.

Hepatic failure

 

Genetic (without hypoglycaemia)

  • Mitochondrial disorders
  • Pyruvate dehydrogenase deficiency

Pyruvate. Muscle biopsy - histology; Enzyme assays and Molecular genetics - consult pathologist before biopsy.

Genetic (with hypoglycaemia)

  • Type l glycogen disease

Glucose, Pyruvate. Liver biopsy with histology, Enzyme studies, Glycogen - consult pathologist before biopsy.

D-lactic acidosis

  • Bowel bacterial overgrowth

D-lactate - consult pathologist.

Respiratory alkalosis

The associated, compensatory, metabolic acidosis often includes elevation of plasma lactate. See Alkalosis

Artefactual

Prolonged storage of blood at room temperature before separation. See Table 1.



Go Back

Page last updated:

Copyright © 2019 RCPA. All rights reserved.

02-Feb-2015
Top