Lactic acidosis

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Clinical Features

Differential Diagnosis

Elevated Serum Lactate - New Page.jpeg

Lactic acidosis

By Type

  • Type A (tissue hypoperfusion)
  • Type B (decreased utilization)
  • Type D
    • episodes of encephalopathy and metabolic acidosis typically following high carbohydrate meals in patients with short bowel syndrome
    • metabolic acidosis and high serum anion gap, normal lactate level, short bowel syn or other forms of malabsorption, and characteristic neurologic findings
      • Type D lactate is not detected with standard lactate levels

Complete List


  • Hyperlactatemia = Lactate >2 mEq/L
  • Lactic Acidosis = Lactate >4 mEq/L

Lactate False Positives


  • Treat underlying cause


  • Depends on underlying cause

See Also

External Links


  1. Dodda V and Spiro P. Albuterol, an Uncommonly Recognized Culprit in Lactic Acidosis. Chest. 2011;140.
  2. . Zitek T, Cleveland N, Rahbar A, et al. Effect of nebulized albuterol on serum lactate and potassium in healthy subjects. Acad Emerg Med 2016;23:718–21.
  3. 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
  4. 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