Causes and risk factors
Lactic acidosis is caused by 2 main reasons – increased lactate production or decreased lactate utilization by liver. When muscle tissues are deprived of oxygen, (e.g., weight training exercise) energy is derived from anaerobic respiration. Lactate is a byproduct of anaerobic respiration. It is normally cleared from the blood by liver, kidney, and skeletal muscles. Persistent deprivation of oxygen and oxygen debt in muscles lead to accumulation of lactic acid in blood and thus to lactic acidosis. There are several causes of lactic acidosis. These include severe muscular exercise, hypoxia, and hypoperfusion, regional hypoperfusion, and hemorrhage. Conditions like hepatic disease, diabetic ketoacidosis, ethanol toxicity, sepsis, shock can also cause lactic acidosis. Diseases that can cause lactic acidosis include cancer, non-Hodgkin’s and Burkitt lymphoma. Chronic alcoholism can also cause lactic acidosis. Certain medications may lead to the condition.
Clinical presentation
Patient with lactic acidosis present with abdominal pain. There is lethargy. Hyperventilation occurs. There is low blood pressure, irregular heart rhythm, high heart rate, rapid pulse. There can occur nausea, vomiting. Severe anemia may occur. Slurred speech, confusion, altered mental status, and ataxia can occur. Patient may end up in shock.
Investigations
Medical history by the patient and clinical examination by the doctor helps in diagnosis. A lactic acid blood test is done that measures the level of lactic acid in the body.
Treatment
Treatment depends upon the underlying cause. The main treatment for lactic acidosis is to correct the underlying problem that lead to it. Additional treatments may be given to support circulation and oxygen supplementation to the tissues. These include intravenous administration of fluids, mechanical ventilation to help enhance oxygen delivery to the lungs, oxygen therapy to boost oxygen availability. Other treatments such as vitamin therapy, dialysis may be required.
Complications
Complications of untreated lactic acidosis can be severe, even life threatening in some cases. They include arrhythmias, decreased athletic performance, sepsis, shock, unconsciousness, and coma.
When to Contact a Doctor
One must consult a doctor if symptoms such as difficulty in breathing or hyperventilation occur.
Prevention
Adequate tissue oxygen perfusion is necessary to prevent the disease.
Systems involved
Circulatory system, musculoskeletal system.
Organs involved
Muscles, liver, kidney.
