Health Dictionary
Reliable, easy-to-read patient information on common medical conditions — written in plain language, free of jargon, and grounded in current evidence. Browse the most frequent diagnoses, understand what they mean for everyday life, and learn which steps and questions help you have a focused conversation with your doctor.
Lactic acidosis (Assessment and Plan)
Introduction
Author: William J Gibson MD, PhD
# Lactic acidosis
Noted to have lactate of XX. Bicarb XX and ABG revealed pH XX. Most likely cause of elevated lactate is hypoperfusion due to XX, though differential includes both type A and type B etiologies as below.
Differential includes:
Type A (hypoperfusion): septic vs cardiogenic shock
Type B (no hypoperfusion): liver disease, diabetes, malignancy, alcoholism, beta agonists, mitochondrial dysfunction, drugs ( salicylates, NRTI, propofol, linezolid), regional ischemia
D-lactic acidosis (rare): short gut, DKA
Dx:
– Lactate Q6H, ABG, tox screen, LFTs
Tx:
– Treat underlying cause
– IV fluids (eg 1L LR bolus)
– Consider thiamine and riboflavin supplementation