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Lactate (Lactic Acid)

Lactic acid is the product of anaerobic glycolysis and exists in the blood entirely as lactate ion. Lactic acidosis is defined as a plasma lactate level higher than 5 meq/L with a pH of less than 7.35. Laboratory findings typically include decreased blood pH, decreased bicarbonate level, decreased pCO2, and increased lactate. Anion gap is typically, but not always, increased.

Raised blood lactate concentrations may result from either increased production by tissues or decreased clearance by the liver. In addition, some drugs, toxins and inborn errors of metabolism can produce lactic acidosis.

Increased Production

  • Shock
  • Hypoxemia
  • Severe anemia
  • Grand mal seizure
  • Severe asthma
  • Sepsis
  • D-lactic acidosis
  • Malignancy

Decreased Clearance

  • Liver failure
  • Malignancy

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