Lactic acidosis (acquired)

Acquired causes of lactic acidosis

Type A: Due to tissue hypoxia

  • Tissue hypoperfusion
    • Abnormal vascular tone or permeability
    • Left ventricular failure
    • Decreased cardiac output
  • Reduced arterial oxygen content
    • Asphyxia
    • Hypoxaemia (PaO2 <35 mmHg)
    • Carbon monoxide poisoning
    • Life-threatening anaemia

Type B: Not due to tissue hypoxia

  • Common disorders
    • Sepsis
    • Hepatic failure
    • Renal failure
    • Diabetes mellitus
    • Cancer, Malaria, Cholera
  • Drugs or toxins
    • Biguanides,  Nalidixic acid,  Isoniazid
    • Ethanol, Methanol, Ethylene glycol
    • Salicylates, Cyanide, Nitroprusside
    • Catecholamines, Theophylline, Sorbitol
    • Lactulose, Parenteral nutrition, Paraldehyde
    • Cocaine, Paracetamol, Vitamin deficiency
    • Streptozotocin, Niacin, Diethyl ether
    • Papaverine
  • Other conditions
    • Strenuous muscular exercise
    • Grand mal seizures
    • D-lactic acidosis

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Causes high anion gap metabolic acidosis