What causes impaired tissue oxygenation in lactic acidosis?

Updated: Dec 09, 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) 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 morbidity, mortality, hospital length of stay, and, often, associated cost. In those circumstances in which hypotension or systemic hypoperfusion are not present (type B), the underlying cause should be further investigated. Ongoing research into lactic acidosis and lactate clearance, as well as noninvasive surrogate measures for early detection of lactic acidosis and guided intervention for critical illnesses, may add further insight into outcome-based practices and future care considerations.

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