Lactic Acidosis, Type A
Lactie acidosis is a metabolic acidosis caused by accumulation of lactate and hydrogen ion, accompanied by elevated blood lactate concentration. That lactic acidosis which is due to inadequate tissue oxygenation, termed Type A lactic acidosis, is one of the more common causes of metabolic acidosis encountered in our anesthetic practice. Lactic acidosis falls into that category of metabolic acidosis associated with an increased acid content (reflected by an increased anion gap: Na-(Cl + CO2)) rather than a decrease in base (normal anion gap). Lactic acidosis may also result from interference disruption of carbohydrate metabolism, termed Type B lactic acidosis. Lactic acidosis may or may not be associated with acidemia depending upon both the physiological and physiochemical buffering capabilities of the organism. We will focus our attention on Type A Lactic Acidosis as we proceed to review the metabolism (biochemistry and physiology), clinieal manifestations, pathophysiology, and therapy (1,2), including recent concerns about the use of sodium bicarbonate.
KeywordsMetabolic Acidosis Lactic Acidosis Sodium Bicarbonate Glycogen Storage Disease Blood Lactate Concentration
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