EMed

Lactic acidosis (acquired)

Acquired causes of lactic acidosis

Type A: Due to tissue hypoxia

  • Tissue hypoperfusion
    • Abnormal vascular tone or permeability
    • LVF
    • ↓ cardiac output
  • ↓ arterial oxygen content
    • Asphyxia
    • Hypoxaemia (PaO2 <35 mmHg)
    • Carbon monoxide poisoning
    • Life-threatening anaemia

Type B: Not due to tissue hypoxia

  • Common disorders:
    • Sepsis
    • Hepatic failure
    • Renal failure
    • Diabetes mellitus
    • Cancer, Malaria, Cholera
  • Drugs or toxins:
    • Biguanides, Nalidixic acid, Isoniazid
    • Ethanol, Methanol, Ethylene glycol
    • Salicylates, Cyanide, Nitroprusside
    • Catecholamines, Theophylline, Sorbitol
    • Lactulose, Parenteral nutrition, Paraldehyde
    • Cocaine, Paracetamol, Vitamin deficiency
    • Streptozotocin, Niacin, Diethyl ether
    • Papaverine
  • Other conditions:
    • Strenuous muscular exercise
    • Grand mal seizures
    • D-lactic acidosis

Content by Dr Íomhar O' Sullivan.   Published 07/10/2002.  Reviewed by Dr ÍOS 03/05/04, 13/05/2007. Next review 13/05/2008