Sunday, 5 April 2015

Lactic acidosis

Classification of Some Causes of Lactic Acidosis (Cohen & Woods, 1976)

Type A Lactic Acidosis : Clinical Evidence of Inadequate Tissue Oxygen Delivery

- Anaerobic muscular activity (eg sprinting, generalised convulsions)

- Tissue hypoperfusion (eg shock -septic, cardiogenic or hypovolaemic; hypotension; cardiac arrest; acute heart failure; regional hypoperfusion esp mesenteric ischaemia; malaria8,9)

- Reduced tissue oxygen delivery or utilisation (eg hypoxaemia, carbon monoxide poisoning, severe anaemia)

Type B Lactic Acidosis: No Clinical Evidence of Inadequate Tissue Oxygen Delivery

type B1 : Associated with underlying diseases (eg ketoacidosis, leukaemia, lymphoma, AIDS)

type B2: Assoc with drugs & toxins (eg phenformin, cyanide, beta-agonists, methanol, nitroprusside infusion, ethanol intoxication in chronic alcoholics, anti-retroviral drugs)

type B3: Assoc with inborn errors of metabolism (eg congenital forms of lactic acidosis with various enzyme defects eg pyruvate dehydrogenase deficiency

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