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Lactic acidosis: pathophysiology, diagnosis and treatment
A van der Beek1, P H de Meijer, A E Meinders
1Department of General Internal Medicine, Leiden University Medical Center, Albinusdreef 2, 2300 RC, Leiden, The Netherlands. babe.beek@wxs.nl
The Netherlands Journal of Medicine
|March 14, 2001
Summary
Lactic acidosis, common in critically ill patients, often occurs with other acid-base disorders. Treatment focuses on underlying causes, as direct lactic acidosis interventions are ineffective, but mortality remains high.
Area of Science:
- Critical Care Medicine
- Nephrology
- Internal Medicine
Background:
- Lactic acidosis is a frequent metabolic derangement in critically ill patients.
- Acid-base disturbances require careful diagnosis and management in severe illness.
Observation:
- This study presents four cases of patients with lactic acidosis co-occurring with other acid-base disturbances.
- Combined acid-base disorders present diagnostic and therapeutic challenges in severe illness.
Findings:
- No specific treatment exists for lactic acidosis itself.
- Effective management necessitates addressing the root causes of the acid-base imbalances.
- The presence of combined disturbances does not alter the high mortality associated with lactic acidosis.
Implications:
- Clinicians must consider and evaluate for combined acid-base disturbances in patients with lactic acidosis.
- Prompt identification and treatment of underlying etiologies are crucial for patient outcomes.
- Despite advances, lactic acidosis in severely ill patients continues to carry a significant risk of mortality.