Summary about Disease
Lactic acidosis is a condition characterized by a buildup of lactic acid in the bloodstream. Lactic acid is produced when the body breaks down carbohydrates for energy, especially during periods of intense exercise or when oxygen levels are low. Normally, the body can clear lactic acid quickly. However, when production exceeds clearance, lactic acidosis occurs. It's a serious condition that can lead to organ damage and even death if left untreated. There are several types of lactic acidosis, each with different underlying causes.
Symptoms
Symptoms can vary in severity and may include:
Rapid breathing (hyperventilation)
Shortness of breath
Confusion
Weakness
Fatigue
Nausea
Vomiting
Abdominal pain
Muscle cramps
Feeling generally unwell (malaise)
In severe cases: coma and potentially death
Causes
Lactic acidosis can be caused by a variety of factors, broadly categorized as:
Type A (Hypoxic): Insufficient oxygen delivery to tissues. This can result from:
Shock (e.g., septic, cardiogenic)
Heart failure
Severe anemia
Carbon monoxide poisoning
Severe lung disease
Type B (Non-Hypoxic): Not related to oxygen delivery. This can result from:
B1: Underlying diseases: Liver failure, kidney failure, cancer, sepsis
B2: Drugs and toxins: Metformin (rarely), certain antiretrovirals, cyanide, alcohol poisoning, salicylates
B3: Inborn errors of metabolism: Genetic conditions that affect the body's ability to process energy
Medicine Used
Treatment focuses on addressing the underlying cause and supporting vital functions. Medications might include:
Sodium bicarbonate: To help neutralize the excess acid in the blood (though its use is controversial and depends on the severity and type of acidosis).
IV fluids: To improve circulation and kidney function.
Vasopressors: To raise blood pressure in cases of shock.
Antibiotics: To treat underlying infections like sepsis.
Specific antidotes: If the lactic acidosis is caused by a toxin (e.g., cyanide).
Insulin and glucose: In certain cases, to promote glucose utilization and reduce lactate production.
Is Communicable
Lactic acidosis itself is not communicable. It is not an infectious disease and cannot be spread from person to person.
Precautions
Precautions depend on the underlying cause. General precautions include:
Managing underlying conditions: Properly treating conditions like diabetes, kidney disease, and heart failure.
Avoiding excessive alcohol consumption: Which can contribute to lactic acid buildup.
Monitoring medication side effects: Being aware of the potential for medications like metformin to rarely cause lactic acidosis and reporting any symptoms to a doctor.
Maintaining adequate hydration: Especially during exercise.
Seeking prompt medical attention: If you experience symptoms of lactic acidosis, especially if you have underlying medical conditions.
How long does an outbreak last?
There isn't an "outbreak" of lactic acidosis, as it is not an infectious disease. The duration of lactic acidosis depends entirely on the underlying cause and how quickly it can be treated. It can resolve within hours with prompt treatment of the underlying cause, or it can persist for days or even weeks if the cause is chronic or difficult to manage.
How is it diagnosed?
Diagnosis typically involves:
Blood tests: Measuring blood lactate levels (a key indicator). Arterial blood gas analysis provides pH and lactate levels.
Arterial Blood Gas (ABG): Measures blood pH and other parameters. A low pH (acidemia) is often present in lactic acidosis.
Review of medical history: Identifying potential underlying causes (e.g., medications, diseases).
Physical examination: Assessing symptoms and vital signs.
Further testing: To determine the underlying cause (e.g., blood cultures to rule out infection, imaging studies to assess tissue oxygenation).
Timeline of Symptoms
The onset and progression of symptoms depend on the underlying cause and severity.
Acute lactic acidosis (e.g., due to shock): Symptoms can develop rapidly, over hours.
Chronic lactic acidosis (e.g., due to underlying disease): Symptoms may develop gradually over days or weeks.
The timeline can vary greatly depending on the individual and the circumstances.
Important Considerations
Lactic acidosis is a serious medical condition that requires prompt diagnosis and treatment.
The underlying cause must be identified and addressed to effectively manage the condition.
Treatment is often supportive, focusing on improving oxygen delivery, correcting electrolyte imbalances, and addressing the underlying cause.
Individuals with underlying medical conditions are at higher risk of developing lactic acidosis.
Metformin-associated lactic acidosis (MALA) is rare, but can be life-threatening, especially in patients with kidney disease.
Early recognition and intervention are crucial for improving outcomes.