Lactic Acidosis


Cohen-Woods Classification of Lactic Acidosis


Etiology

Genetic Diseases

Malignancy/Malignancy-Related

Shock States

Liver Disease

D-Lactic Acidosis Due to Production by Enteric Microbes

Drugs

Toxins

Other


Physiology

Normal Lactate Physiology

Lactate Generation and Consumption


Diagnosis

Serum Lactate (see Serum Lactate, [[Serum Lactate]])

Serum Osmolal Gap (see Serum Osmolality, [[Serum Osmolality]])

Serum Anion Gap (see Serum Anion Gap, [[Serum Anion Gap]])

Delta Gap/Delta Bicarbonate Ratio


Clinical Manifestations

Physiologic Effects of Acute Metabolic Acidosis

Cardiovascular Manifestations

Gastrointestinal Manifestations

Renal Manifestations

Anion Gap Metabolic Acidosis (AGMA) (see Metabolic Acidosis-Elevated Anion Gap, [[Metabolic Acidosis-Elevated Anion Gap]])

Non-Anion Gap Metabolic Acidosis (NAGMA) (see Metabolic Acidosis-Normal Anion Gap, [[Metabolic Acidosis-Normal Anion Gap]])

Other Manifestations


Treatment

Supportive Care

Restoration of Tissue Perfusion

Packed Red Blood Cells (PRBC) (see Packed Red Blood Cells, [[Packed Red Blood Cells]])

Oxygen/Mechanical Ventilation (see Oxygen, [[Oxygen]] and General Ventilator Management, [[General Ventilator Management]]))

Specific Treatment of Underlying Disorder

Improvement of the Microcirculation

Sodium Bicarbonate (see Sodium Bicarbonate, [[Sodium Bicarbonate]])

Hemodialysis (see Hemodialysis, [[Hemodialysis]])

Other Unproven Therapies

Monitoring of Serum Lactate (see Serum Lactate, [[Serum Lactate]])


References