Lactic Acidosis - Overview and Pathophysiology
Lactic acid is an endogenous substrate for gluconeogenesis, that is constantly produced by muscle and other tissues and is increased with exercise/activity. Lactic acid is non-toxic, though it importantly can be a marker for severity of underlying disease.
Lactate is the conjugate base of lactic acid (this is why LR does not cause acidosis)
Lactic Acidosis is defined as an arterial lactate level ≥ 2 mmol/L PLUS a pH < 7.35
TYPE A: Impaired O2 Delivery (DO2)
 • Decreased O2 Delivery
 • Increased O2 Demand
TYPE B: Impaired O2 Utilization (VO2)
 • Drugs/Toxins
 • Impaired Clearance
 • Other
TYPE D: Bacterial Overgrowth

by Mark Ramzy, DO, EMT-P @MRamzyDO and Nick Mark MD @nickmmark

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