Related Experiment Videos
Severe perioperative lactic acidosis: how clinically significant is it?
J F O'Hara1, J E Tetzlaff, M P Smith
1Department of General Anesthesiology, Cleveland Clinic Foundation, OH 44195.
Cleveland Clinic Journal of Medicine
|July 1, 1994
Summary
Perioperative lactic acidosis, a buildup of lactate in the blood during surgery, can be severe but is often temporary. This case shows that transient lactic acidosis does not necessarily predict mortality, unlike chronic elevations seen in sepsis.
Area of Science:
- Anesthesiology
- Critical Care Medicine
- Gastroenterology
Background:
- Lactic acidosis, defined by plasma lactate >5 mmol/L and pH <7.25, is linked to increased mortality.
- Perioperative lactic acidosis requires careful evaluation for underlying causes and patient outcomes.
Observation:
- A 40-year-old male with Crohn's disease experienced severe, unexplained perioperative lactic acidosis during major abdominal surgery.
- Plasma lactate levels peaked at 16.9 mmol/L, significantly above the normal range of 1.5–2.2 mmol/L.
Findings:
- The patient's lactic acidosis resolved spontaneously within 14 hours without adverse effects.
- This transient, severe lactic acidosis did not correlate with long-term negative outcomes.
Implications:
- Reversible perioperative lactic acidosis may not carry the same mortality risk as chronic lactic acidosis in conditions like sepsis.
- Recognizing self-limiting causes of perioperative lactate elevation is crucial for accurate prognosis and patient management.