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Lactic acidosis and acute ethanol intoxication

L MacDonald1, J A Kruse, D B Levy

  • 1Division of Critical Care Medicine, Wayne State University School of Medicine, Detroit, MI.

The American Journal of Emergency Medicine
|January 1, 1994
PubMed
Summary

Acute ethanol intoxication rarely causes significant lactic acidosis. In patients with alcohol intoxication and elevated lactate, other causes should be investigated to ensure proper diagnosis and treatment.

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Area of Science:

  • Medical Research
  • Toxicology
  • Emergency Medicine

Background:

  • Ethanol intoxication is frequently cited as a cause of lactic acidosis.
  • The actual incidence and severity of ethanol-induced lactic acidosis require further investigation.

Purpose of the Study:

  • To determine the frequency and severity of lactic acidosis in patients with acute ethanol intoxication.
  • To assess the contribution of ethanol to elevated blood lactate levels.

Main Methods:

  • Studied 60 patients presenting to the emergency department with acute ethanol intoxication (serum ethanol ≥ 100 mg/dL).
  • Collected arterial blood samples for lactate and blood gas analysis.
  • Evaluated for other potential causes of lactic acidosis.

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Main Results:

  • Elevated lactate concentrations (> 2.4 mmol/L) were found in 11.7% of patients (7 out of 60).
  • Blood lactate levels in affected patients were below 5 mmol/L.
  • Other causes of lactic acidosis (hypoxia, seizures, hypoperfusion) were present in patients with elevated lactate; only one patient had acidemia.

Conclusions:

  • Significant elevations in blood lactate are uncommon in acute ethanol intoxication.
  • When lactic acidosis is identified in patients with ethanol intoxication, alternative etiologies must be considered.