lacticacidose

Lactic acidosis, also known as lactic acidemia, is a metabolic condition characterized by the excessive accumulation of lactate in the blood, leading to a dangerous drop in blood pH and an abnormal state called acidosis. Lactate is a byproduct of anaerobic metabolism, a process that occurs when oxygen levels are insufficient to meet the body’s energy demands. While small amounts of lactate are normally present and can be safely metabolized by the liver, lactic acidosis arises when its production exceeds the body’s ability to clear it, disrupting acid-base balance.

The condition can be classified as either type A or type B. Type A lactic acidosis is typically associated with severe clinical conditions such as shock, sepsis, severe hypoxia, or prolonged exercise, where tissue oxygenation is compromised. Type B lactic acidosis is less directly linked to hypoxia and may stem from underlying metabolic disorders, medications (such as biguanides like metformin), liver disease, or inherited enzymatic deficiencies that impair lactate metabolism.

Symptoms of lactic acidosis may include rapid breathing, nausea, vomiting, abdominal pain, muscle weakness, and in severe cases, confusion, coma, or cardiac arrhythmias. Diagnosis often involves measuring blood lactate levels, arterial blood gas analysis to confirm acidosis, and assessing potential underlying causes through medical history and laboratory tests.

Treatment focuses on addressing the root cause, such as improving oxygen delivery in hypoxic states or discontinuing offending medications. Supportive care may include intravenous fluids, bicarbonate therapy (in extreme cases), and correction of electrolyte imbalances. In chronic or inherited forms, management may require long-term monitoring and specialized medical intervention.

Early recognition and prompt treatment are critical, as lactic acidosis can progress rapidly and become life-threatening if untreated. Prevention strategies include managing underlying conditions, avoiding excessive exertion in compromised individuals, and adhering to prescribed medications.