Lactic acidosis: from sour milk to septic shock

Journal of Intensive Care Medicine
Pamela J Fall, Harold M Szerlip


Lactic acidosis is frequently encountered in the intensive care unit. It occurs when there is an imbalance between production and clearance of lactate. Although lactic acidosis is often associated with a high anion gap and is generally defined as a lactate level >5 mmol/L and a serum pH <7.35, the presence of hypoalbuminemia may mask the anion gap and concomitant alkalosis may raise the pH. The causes of lactic acidosis are traditionally divided into impaired tissue oxygenation (Type A) and disorders in which tissue oxygenation is maintained (Type B). Lactate level is often used as a prognostic indicator and may be predictive of a favorable outcome if it normalizes within 48 hours. The routine measurement of serum lactate, however, should not determine therapeutic interventions. Unfortunately, treatment options remain limited and should be aimed at discontinuation of any offending drugs, treatment of the underlying pathology, and maintenance of organ perfusion. The mainstay of therapy of lactic acidosis remains prevention.


Jul 1, 1977·American Journal of Clinical Pathology·C T AndersonM L Birnbaum
Jan 1, 1978·Annals of Clinical Biochemistry·J F Zilva
Mar 10, 1977·The New England Journal of Medicine·G Weber
Jan 1, 1977·Medicine·M Emmett, R G Narins
Mar 1, 1978·The American Journal of Clinical Nutrition·F E Wells, B J Smits
Aug 2, 1979·The New England Journal of Medicine·M S OhH J Carroll
Jan 1, 1978·Annals of Internal Medicine·S H Humphrey, D A Nash
May 1, 1976·Annals of Internal Medicine·H Dash, J Mills
Aug 1, 1992·Archives of Internal Medicine·M M Salem, S K Mujais
May 1, 1992·Journal of Applied Physiology·F J HurtadoG Gutierrez
Apr 1, 1991·Southern Medical Journal·T P EarthmanC A Mullins
Jun 1, 1990·The American Journal of Physiology·C H Orchard, J C Kentish
Nov 1, 1989·Metabolism: Clinical and Experimental·P W Stacpoole
Feb 1, 1985·Kidney International·P A Gabow
Feb 1, 1986·The American Journal of Medicine·M FulopJ S Gage
Apr 26, 1986·British Medical Journal·P D Mason
May 1, 1986·JPEN. Journal of Parenteral and Enteral Nutrition·R F Kushner
Dec 1, 1986·Annals of Internal Medicine·L R MorrisA E Kitabchi
Dec 1, 1988·The American Journal of Medicine·R M Bersin, A I Arieff
Apr 1, 1988·Annals of Internal Medicine·R M LangK M Borow
Jul 24, 1987·JAMA : the Journal of the American Medical Association·B A Mizock
Sep 1, 1987·American Journal of Kidney Diseases : the Official Journal of the National Kidney Foundation·N E MadiasS Herson
Mar 1, 1986·Kidney International·N E Madias
Oct 1, 1985·Annals of Internal Medicine·N S MannM F Tsai
May 1, 1985·JPEN. Journal of Parenteral and Enteral Nutrition·T Ramakrishnan, P Stokes
Jul 1, 1985·The American Journal of Physiology·J V Bonventre, J Y Cheung
Mar 3, 1973·Lancet·J W Rickett, D J Bowen
Nov 1, 1972·Australian and New Zealand Journal of Medicine·J M SheppardP H Wise
Jan 1, 1974·Annals of the New York Academy of Sciences·J B Block
Jan 1, 1972·Journal of Applied Physiology·J B Osnes, L Hermansen
Aug 1, 1969·Postgraduate Medical Journal·R SchröderR M Zollinger
Jun 1, 1968·The American Journal of Physiology·K WildenthalJ H Mitchell
Nov 1, 1966·Journal of Applied Physiology·L B RowellF Kusumi
Nov 1, 1980·The American Journal of Physiology·C Eyzaguirre, S J Fidone
Jan 1, 1981·International Journal of Nuclear Medicine and Biology·J Baldas, P M Pojer

❮ Previous
Next ❯


Jun 18, 2009·Intensive Care Medicine·Daniel DobererBruno Schneeweiss
May 15, 2008·Pediatric Critical Care Medicine : a Journal of the Society of Critical Care Medicine and the World Federation of Pediatric Intensive and Critical Care Societies·Kourosh ParsapourRobert Pretzlaff
Apr 21, 2012·Current Opinion in Critical Care·Brian M Fuller, R Phillip Dellinger
Apr 5, 2011·Pediatric Critical Care Medicine : a Journal of the Society of Critical Care Medicine and the World Federation of Pediatric Intensive and Critical Care Societies·Kathleen L MeertAshok P Sarnaik
Oct 1, 2008·Journal of Veterinary Internal Medicine·J ElfenbeinA Woolums
Mar 26, 2009·Journal of Veterinary Internal Medicine·K WotmanR C Boston
Nov 21, 2009·Journal of Veterinary Internal Medicine·B S Tennent-BrownR C Boston
Sep 16, 2006·American Journal of Respiratory and Critical Care Medicine·Pedro P EspañaJosé M Quintana
Aug 4, 2012·Journal of Medical Case Reports·Simon TimbrellAlan Liddle
May 15, 2013·Annals of Intensive Care·Jan BakkerTim C Jansen
Oct 22, 2011·Critical Care : the Official Journal of the Critical Care Forum·Alistair NicholRinaldo Bellomo
Jun 16, 2009·Critical Care : the Official Journal of the Critical Care Forum·Houman KhosravaniKevin B Laupland
Apr 5, 2011·Critical Care : the Official Journal of the Critical Care Forum·Anke P C TopCan Ince
Oct 23, 2012·Journal of Zoo and Wildlife Medicine : Official Publication of the American Association of Zoo Veterinarians·Anne Burgdorf-MoisukKate Hopper
Aug 27, 2013·Journal of the American Veterinary Medical Association·Jessica E MarkovichLisa M Freeman
Jan 14, 2010·Case Reports in Medicine·Farn Huei ChanLaurel J Lyckholm
Jul 14, 2014·The Veterinary Clinics of North America. Equine Practice·Brett Tennent-Brown
Sep 8, 2007·Journal of the American Animal Hospital Association·Daniel S Pang, Søren Boysen
Dec 11, 2014·The New England Journal of Medicine·Jeffrey A Kraut, Nicolaos E Madias
Dec 22, 2010·Expert Review of Anti-infective Therapy·Stephen W Standage, Hector R Wong
Aug 14, 2010·Clinical Toxicology : the Official Journal of the American Academy of Clinical Toxicology and European Association of Poisons Centres and Clinical Toxicologists·Alex F ManiniRobert S Hoffman
Jul 24, 2012·Biomarkers : Biochemical Indicators of Exposure, Response, and Susceptibility to Chemicals·Yonathan FreundPierre Hausfater
Feb 3, 2016·The American Journal of Emergency Medicine·Ali PourmandHamid Shokoohi
Dec 15, 2015·Journal of Hepatology·Martin-Walter WelkerChristoph Sarrazin
Jan 17, 2016·Metabolism: Clinical and Experimental·Ralph DeFronzoThomas A Bicsak
Sep 25, 2012·Intensive & Critical Care Nursing : the Official Journal of the British Association of Critical Care Nurses·Martin Christensen, Fiona Chen
May 24, 2011·American Journal of Kidney Diseases : the Official Journal of the National Kidney Foundation·Chong Parke, Yeong-Hau H Lien
May 17, 2011·The Journal of Surgical Research·Emily MiraflorGregory P Victorino
Jan 26, 2010·Clinica Chimica Acta; International Journal of Clinical Chemistry·Qing H MengJohn Krahn
Mar 3, 2009·Journal of Pharmaceutical and Biomedical Analysis·Elliott J FrancoOliver Hofstetter
Jun 6, 2014·Scientific Reports·Abhinav P AcharyaNiren Murthy
Jul 31, 2010·Acta Clinica Belgica·H M Soliman, J-L Vincent
Nov 1, 2012·Journal of Veterinary Emergency and Critical Care·Pedro De PedroRaymond C Boston
Dec 1, 2013·Equine Veterinary Journal. Supplement·A BorchersR C Boston
Oct 16, 2015·International Journal of Legal Medicine·T KeltanenK Lindroos
Sep 14, 2007·Hematology·Jeddi RamziMeddeb Balkis
Apr 30, 2013·Microbial Pathogenesis·David E KlingDavid S Newburg
Jul 29, 2015·BMC Anesthesiology·Nicolas De SchryverDiego Castanares-Zapatero

❮ Previous
Next ❯

Related Concepts

Trending Feeds


Coronaviruses encompass a large family of viruses that cause the common cold as well as more serious diseases, such as the ongoing outbreak of coronavirus disease 2019 (COVID-19; formally known as 2019-nCoV). Coronaviruses can spread from animals to humans; symptoms include fever, cough, shortness of breath, and breathing difficulties; in more severe cases, infection can lead to death. This feed covers recent research on COVID-19.


Blastomycosis fungal infections spread through inhaling Blastomyces dermatitidis spores. Discover the latest research on blastomycosis fungal infections here.

Nuclear Pore Complex in ALS/FTD

Alterations in nucleocytoplasmic transport, controlled by the nuclear pore complex, may be involved in the pathomechanism underlying multiple neurodegenerative diseases including Amyotrophic Lateral Sclerosis and Frontotemporal Dementia. Here is the latest research on the nuclear pore complex in ALS and FTD.

Applications of Molecular Barcoding

The concept of molecular barcoding is that each original DNA or RNA molecule is attached to a unique sequence barcode. Sequence reads having different barcodes represent different original molecules, while sequence reads having the same barcode are results of PCR duplication from one original molecule. Discover the latest research on molecular barcoding here.

Chronic Fatigue Syndrome

Chronic fatigue syndrome is a disease characterized by unexplained disabling fatigue; the pathology of which is incompletely understood. Discover the latest research on chronic fatigue syndrome here.

Evolution of Pluripotency

Pluripotency refers to the ability of a cell to develop into three primary germ cell layers of the embryo. This feed focuses on the mechanisms that underlie the evolution of pluripotency. Here is the latest research.

Position Effect Variegation

Position Effect Variagation occurs when a gene is inactivated due to its positioning near heterochromatic regions within a chromosome. Discover the latest research on Position Effect Variagation here.

STING Receptor Agonists

Stimulator of IFN genes (STING) are a group of transmembrane proteins that are involved in the induction of type I interferon that is important in the innate immune response. The stimulation of STING has been an active area of research in the treatment of cancer and infectious diseases. Here is the latest research on STING receptor agonists.


Microbicides are products that can be applied to vaginal or rectal mucosal surfaces with the goal of preventing, or at least significantly reducing, the transmission of sexually transmitted infections. Here is the latest research on microbicides.