Lactic acidosis

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Background

  • Most common cause of metabolic acidosis in hospitalized patients

DDX

  • Type A
    • Impaired tissue oxygenation
      • Hypovolemia
      • Cardiac failure
      • Sepsis
      • CO poisoning
      • CN poisoning
  • Type B
    • No impaired tissue oxygenation
      • Alcoholism
        • Lactate utilization is impaired 2/2:
          • 1. Impaired hepatic gluconeogenesis
          • 2. No NAD to convert lactate to pyruvate
      • Sepsis
      • Liver disease
      • Metformin

Source

Tintinalli

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