Lactic acidosis

Background

Most common cause of metabolic acidosis in hospitalized patients

DDX

1. Type A
   1. Impaired tissue oxygenation
      1. Hypovolemia
      2. Cardiac failure
      3. Sepsis
      4. CO poisoning
      5. CN poisoning
2. Type B
   1. No impaired tissue oxygenation
      1. Alcoholism
         1. Lactate utilization is impaired 2/2 impaired hepatic gluconeogenesis
      2. Liver disease
      3. Metformin