View source for Lactic acidosis

==Background==
*Most common cause of [[metabolic acidosis]] in hospitalized patients

==Clinical Features==
*Anorexia
*[[Nausea]]
*[[Vomiting]]
*[[Abdominal pain]]
*[[Lethargy]]
*[[Hyperventilation]]
*[[Hypotension]]

==Differential Diagnosis==
[[File:Elevated Serum Lactate - New Page.jpeg|thumb]]
{{Lactic acidosis DDX}}

==Evaluation==
*Hyperlactatemia = Lactate >2 mEq/L
*Lactic Acidosis = Lactate >4 mEq/L 

===Lactate False Positives===
*[[Beta agonists]] or beta stimulation
*Extreme exercise
*[[Seizures]], immediate post-ictal period
*[[Hepatic failure]]
**Lactate ringer's solution unlikely to cause false positive except in hepatic failure<ref>Zitek T, Skaggs ZD, Rahbar A, Patel J, Khan M. Does Intravenous Lactated Ringer's Solution Raise Serum Lactate?. J Emerg Med. 2018;55(3):313-318. doi:10.1016/j.jemermed.2018.05.031</ref><ref>Didwania A, Miller J, Kassel D, Jackson EV Jr, Chernow B. Effect of intravenous lactated Ringer's solution infusion on the circulating lactate concentration: Part 3. Results of a prospective, randomized, double-blind, placebo-controlled trial. Crit Care Med. 1997;25(11):1851-1854. doi:10.1097/00003246-199711000-00024</ref>

==Management==
*Treat underlying cause

==Disposition==
*Depends on underlying cause

==See Also==
*[[EBQ:Lactate clearance vs central venous oxygen saturation]]
*[[HAART-induced lactic acidosis]]

==External Links==
*[http://pemplaybook.org/podcast/big-labs-little-people-troponin-bnp-d-dimer-and-lactate/ Pediatric Emergency Playbook Podcast: Big Labs, Little People]

==References==
<references/>

[[Category:FEN]]
[[Category:ID]]