What causes impaired tissue oxygenation in lactic acidosis?

Updated: Aug 18, 2020
  • Author: Bret A Nicks, MD, MHA; Chief Editor: Romesh Khardori, MD, PhD, FACP  more...
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While lactic acidosis is the most common cause of metabolic acidosis in hospitalized patients, the etiology of impaired tissue oxygenation is variable. Typically associated with systemic hypoperfusion (type A lactic acidosis) leading to increased anaerobic metabolism, early recognition of the clinical signs of hypoperfusion is essential. Additionally, if hypoperfusion exists, early restoration of perfusion is necessary to prevent or limit multiple organ dysfunction, as well as to reduce mortality. In those circumstances in which hypotension or systemic hypoperfusion are not present, type B lactic acidosis and its causes should be investigated.Ongoing research into lactate clearance, and perhaps noninvasive surrogate measures, in many disease modalities will certainly add further insight into outcome-based practices and further considerations.

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