-
PeerJ 2024The relationship between hyperlactatemia and prognosis after cardiopulmonary bypass (CPB) is controversial, and some studies ignore the presence of lactic acidosis in...
BACKGROUND
The relationship between hyperlactatemia and prognosis after cardiopulmonary bypass (CPB) is controversial, and some studies ignore the presence of lactic acidosis in patients with severe hyperlactacemia. This study explored the association between lactic acidosis (LA) and the occurrence of multiple organ dysfunction syndrome (MODS) after cardiopulmonary bypass.
METHODS
This study was a analysis of patients who underwent cardiac surgery between February 2017 and August 2018 and participated in a prospective study at Taizhou Hospital. The data were collected at: ICU admission (H0), and 4, 8, 12, 24, and 48 h after admission. Blood lactate levels gradually increased after CPB, peaking at H8 and then gradually decreasing. The patients were grouped as LA, hyperlactatemia (HL), and normal control (NC) based on blood test results 8 h after ICU admission. Basic preoperative, perioperative, and postoperative conditions were compared between the three groups, as well as postoperative perfusion and oxygen metabolism indexes.
RESULTS
There were 22 (19%), 73 (64%), and 19 (17%) patients in the LA, HL, and NC groups, respectively. APACHE II (24h) and SOFA (24h) scores were the highest in the LA group ( < 0.05). ICU stay duration was the longest for the LA group (48.5 (42.5, 50) h), compared with the HL (27 (22, 48) h) and NC (27 (25, 46) h) groups ( = 0.012). The LA group had the highest incidence of MODS (36%), compared with the HL (14%) and NC (5%) groups ( = 0.015). In the LA group, the oxygen extraction ratio (OER) was lower (21.5 (17.05, 32.8)%) than in the HL (31.3 (24.8, 37.6)%) and the NC group (31.3 (29.0, 35.4) %) ( = 0.018). In the univariable analyses, patient age (OR = 1.054, 95% CI [1.003-1.109], = 0.038), the LA group ( the NC group, (OR = 10.286, 95% CI [1.148-92.185], = 0.037), and ΔPCO2 at H8 (OR = 1.197, 95% CI [1.022-1.401], = 0.025) were risk factor of MODS after CPB.
CONCLUSIONS
We speculated that there was correlation between lactic acidosis and MODS after CPB. In addition, LA should be monitored intensively after CPB.
Topics: Humans; Acidosis, Lactic; Cardiopulmonary Bypass; Hyperlactatemia; Multiple Organ Failure; Prospective Studies; Postoperative Complications; Oxygen
PubMed: 38313014
DOI: 10.7717/peerj.16769 -
Postgraduate Medical Journal May 2004Diabetic ketoacidosis, hyperglycaemic hyperosmolar state, and lactic acidosis represent three of the most serious acute complications of diabetes. There have been some... (Review)
Review
Diabetic ketoacidosis, hyperglycaemic hyperosmolar state, and lactic acidosis represent three of the most serious acute complications of diabetes. There have been some advances in our understanding of the pathogenesis of these conditions over the last three decades, together with more uniform agreement on their treatment and innovations in technology. Accordingly their incidence, morbidity, and mortality are decreasing, but at rates that fall short of our aspirations. Hyperglycaemic crises in particular remain an important cause of morbidity and mortality in diabetic populations around the world. In this article, understanding of these conditions and advances in their management, and the available guidelines for their treatment, are reviewed. As far as is possible, the recommendations are based on clear published evidence; failing that, what is considered to be a common sense synthesis of consensus guidelines and recommendations is provided.
Topics: Acidosis, Lactic; Fluid Therapy; Humans; Hyperglycemic Hyperosmolar Nonketotic Coma; Hypophosphatemia; Insulin; Patient Education as Topic; Potassium; Water-Electrolyte Imbalance
PubMed: 15138313
DOI: 10.1136/pgmj.2002.004291 -
Nefrologia 2019
Topics: Acidosis, Lactic; Acute Kidney Injury; Aged; Contraindications, Drug; Diuretics; Female; Humans; Hypoglycemic Agents; Male; Metformin; Renal Dialysis
PubMed: 31208831
DOI: 10.1016/j.nefro.2019.03.005 -
International Journal of Infectious... Feb 2015The use of linezolid has increased with the emergence of multidrug-resistant bacteria. Serum lactic acidosis has been reported as a serious side effect of linezolid use,...
BACKGROUND
The use of linezolid has increased with the emergence of multidrug-resistant bacteria. Serum lactic acidosis has been reported as a serious side effect of linezolid use, therefore we evaluated the incidence and characteristics of linezolid-related lactic acidosis.
METHODS
Patients admitted to an 860-bed university hospital were enrolled. The patients were divided into two groups, those who used linezolid and those who used teicoplanin (control group). The study was conducted by review of the medical charts.
RESULTS
Seventy-two patients were included in the linezolid group. The control group comprised 72 patients matched to those in the linezolid group for age and indication for antibiotic use. Lactic acidosis occurred in five cases (6.8%) in the linezolid group. None of the patients who used teicoplanin developed lactic acidosis, which was a comparable result. The median change in anion gap in the linezolid group was -0.8 mmol/l (interquartile range (IQR) -3.55 to 1.28 mmol/l), which was significantly higher than in the teicoplanin group, 0.05 mmol/l (IQR -1.75 to 2.3 mmol/l) (p=0.026). The number of increased anion gap events in patients who used linezolid for more than 6 weeks was higher than in the group who used linezolid for less than 6 weeks (p=0.0014). However, no statistically significant difference was observed according to age, estimated glomerular filtration rate, or diabetes.
CONCLUSIONS
Linezolid showed an association with treatment-related lactic acidosis. A longer duration of linezolid use (>6 weeks) was one of the risk factors for metabolic acidosis. We suggest checking serum lactate concentrations regularly, especially in those on long-term use.
Topics: Acidosis, Lactic; Adult; Aged; Anti-Bacterial Agents; Female; Humans; Incidence; Linezolid; Male; Middle Aged; Retrospective Studies; Risk Factors; Teicoplanin
PubMed: 25499040
DOI: 10.1016/j.ijid.2014.12.009 -
Clinical Medicine & Research Mar 2023Metformin, commonly prescribed in diabetic patients, can cause lactic acidosis. Although generally rare, this side effect remains a source of concern in procedures... (Meta-Analysis)
Meta-Analysis Review
Metformin, commonly prescribed in diabetic patients, can cause lactic acidosis. Although generally rare, this side effect remains a source of concern in procedures requiring contrast media, due to the risk of contrast-induced nephropathy. Temporarily withdrawing metformin during the peri-procedural period is often practiced, but clinical decisions are difficult in emergency situations, such as acute coronary syndromes. In this systematic review with meta-analysis, we aimed to further investigate the safety of percutaneous coronary interventions in patients on concurrent metformin therapy. We analyzed studies in patients undergoing (elective or emergency) percutaneous coronary interventions with or without concurrent metformin administration, reporting on the incidence of metformin-associated lactic acidosis and peri-procedural renal function. PubMed, ClinicalTrials.gov, Cochrane Library, and Scopus were systematically searched without language restrictions throughout August 2022. Randomized clinical trials and observational studies were assessed with the Revised Cochrane Collaboration Risk of Bias tool and the Newcastle-Ottawa quality scale, respectively. Data synthesis addressed the mean drop in estimated glomerular filtration rate (eGFR) and the incidence of contrast-induced nephropathy, in addition to lactic acidosis. Nine studies were included, totaling 2235 patients (1076 continuing metformin during the peri-procedural period), mostly with eGFR above 30 mL/min/1.73m No cases of lactic acidosis were reported. The mean post-procedural drop in eGFR was 6.81mL/min/1.73m (95% confidence interval [CI]: 3.41 to 10.21) in the presence of metformin and 5.34 mL/min/1.73m (95% CI: 2.98 to 7.70) in its absence. The incidence of contrast-induced nephropathy was not affected by concurrent metformin, as shown by a (between-groups) standardized mean difference of 0.0007 (95% CI: -0.1007 to 0.1022). Concurrent metformin during percutaneous coronary interventions in patients with relatively preserved renal function is safe, without added risk of lactic acidosis or contrast-induced nephropathy. Thus, emergency revascularization in the context of acute coronary syndromes should not be deferred. More data from clinical trials in patients with severe renal disease are needed.
Topics: Humans; Metformin; Hypoglycemic Agents; Diabetes Mellitus, Type 2; Acidosis, Lactic; Acute Coronary Syndrome; Kidney; Kidney Diseases; Percutaneous Coronary Intervention
PubMed: 37130786
DOI: 10.3121/cmr.2022.1759 -
The Canadian Veterinary Journal = La... Nov 2023Metabolic acidosis (MA) is the most common acid-base disorder reported in horses with colitis but its association with survival is yet to be determined.
BACKGROUND
Metabolic acidosis (MA) is the most common acid-base disorder reported in horses with colitis but its association with survival is yet to be determined.
OBJECTIVE
Investigate the types of MA in horses with colitis to determine effects of various anions on fatality rates.
ANIMALS AND PROCEDURES
We studied 158 horses with colitis. Horses were classified into 4 groups depending on the anion contributing to MA: i) no MA, ii) lactic acidosis (LA), iii) unmeasured strong ion (USI) acidosis, and iv) hyperchloremic acidosis (HA).
RESULTS
Sixty percent (95/158) of horses had no MA, 22% (34/158) had LA, 12% (19/158) had HA, and 6% (10/158) had USI acidosis. The fatality rate of horses without MA was 20% (20/95), whereas the rates for those with LA, USI, and HA were 53% (18/34), 30% (3/10), and 16% (3/19), respectively. Horses with LA were more likely to die or be euthanized than horses without MA (OR: 4.2, 95% CI: 1.83 to 9.72, < 0.001) and HA (OR: 5.9, 95% CI: 1.47 to 24.4, < 0.01).
CONCLUSION AND CLINICAL RELEVANCE
Lactic acidosis was the most common type of MA in horses with colitis, and it was associated with non-survival.
Topics: Animals; Horses; Acidosis, Lactic; Acidosis; Colitis; Horse Diseases
PubMed: 37915775
DOI: No ID Found -
Journal of Dairy Science May 1997Bovine lactic acidosis syndrome is associated with large increases of lactic acid in the rumen, which result from diets that are high in ruminally available... (Review)
Review
Bovine lactic acidosis syndrome is associated with large increases of lactic acid in the rumen, which result from diets that are high in ruminally available carbohydrates, or forage that is low in effective fiber, or both. The syndrome involves two separate anatomical areas, the gastrointestinal tract and body fluids, and is related to the rate and extent of lactic acid production, utilization, and absorption. Clinical manifestations range from loss of appetite to death. Lactic acid accumulates in the rumen when the bacteria that synthesize lactic acid outnumber those that utilize lactic acid. The systemic impact of acidosis may have several physiological implications, including laminitis, a diffuse aseptic inflammation of the laminae (corium). Although a nutritional basis for the disease exists, etiology includes a multitude of interactive factors, such as metabolic and digestive disorders, postpartum stress, and localized trauma, which lead to the release of vasoactive substances that trigger mechanisms that cause degenerative changes in the foot. The severity of laminitis is related to the frequency, intensity, and duration of systemic acidotic insults on the mechanisms responsible for the release of vasoactive substance. The critical link between acidosis and laminitis appears to be associated with a persistent hypoperfusion, which results in ischemia in the digit. Management of acidosis is critical in preventing laminitis. High producing dairy herds attempting to maximize energy intake are continually confronted with subclinical acidosis and laminitis. Management of feeding and husbandry practices can be implemented to reduce incidence of disease.
Topics: Acidosis, Lactic; Animal Nutritional Physiological Phenomena; Animals; Cattle; Cattle Diseases; Dermatitis; Dietary Carbohydrates; Foot Diseases; Hoof and Claw; Hydrogen-Ion Concentration; Lactic Acid; Rumen
PubMed: 9178142
DOI: 10.3168/jds.S0022-0302(97)76026-0 -
International Journal of Environmental... Mar 2023Patient data from the National Database of Health Insurance Claims and Specific Health Checkups of Japan (NDB) are used to assess the effect of biguanide administration...
Patient data from the National Database of Health Insurance Claims and Specific Health Checkups of Japan (NDB) are used to assess the effect of biguanide administration on rates of lactic acidosis (LA) in hospitalized diabetes mellitus (DM) patients. In this retrospective cohort study (from April 2013 to March 2016), we compare DM inpatients prescribed biguanides to DM inpatients who were not prescribed biguanides to quantify the association between biguanides and incidence of LA. In total, 8,111,848 DM patient records are retrieved from the NDB. Of the 528,768 inpatients prescribed biguanides, 782 develop LA. Of the 1,967,982 inpatients not prescribed biguanides, 1310 develop LA. The rate ratio of inpatients who develop LA and are administered biguanides to those who developed LA without receiving biguanides is 1.44 (95% CI, 1.32-1.58). Incidence rates and rate ratios for both sexes are elevated in the group prescribed biguanides for patients aged 70 years and older, markedly in those 80 years and older: 40.12 and 6.31 (95% CI, 4.75-8.39), respectively, for men and 34.96 and 5.40 (95% CI, 3.91-7.46), respectively, for women. Biguanides should be used conservatively in patients older than 70 years, particularly for those with comorbidities, and with caution in patients 80 years and older.
Topics: Male; Humans; Female; Aged; Aged, 80 and over; Biguanides; Acidosis, Lactic; Retrospective Studies; Metformin; Cohort Studies; Japan; Diabetes Mellitus; Inpatients
PubMed: 37047916
DOI: 10.3390/ijerph20075300 -
Journal of Translational Medicine Jun 2017The pursuit for clarity in diagnostic and treatment pathways for the complex, chronic condition of myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS) continues.... (Meta-Analysis)
Meta-Analysis Review
BACKGROUND
The pursuit for clarity in diagnostic and treatment pathways for the complex, chronic condition of myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS) continues. This systematic review raises a novel question to explore possible overlapping aetiology in two distinct conditions. Similar neurocognitive symptoms and evidence of D-lactate producing bacteria in ME/CFS raise questions about shared mechanisms with the acute condition of D-lactic acidosis (D-la).
METHODS
D-la case reports published between 1965 and March 2016 were reviewed for episodes describing both neurological symptoms and high D-lactate levels. Fifty-nine D-la episodes were included in the qualitative synthesis comparing D-la symptoms with ME/CFS diagnostic criteria. A narrative review of D-la mechanisms and relevance for ME/CFS was provided.
RESULTS
The majority of neurological disturbances reported in D-la episodes overlapped with ME/CFS symptoms. Of these, the most frequently reported D-la symptoms were motor disturbances that appear more prominent during severe presentations of ME/CFS. Both patient groups shared a history of gastrointestinal abnormalities and evidence of bacterial dysbiosis, although only preliminary evidence supported the role of lactate-producing bacteria in ME/CFS.
LIMITATIONS
Interpretation of results are constrained by both the breadth of symptoms included in ME/CFS diagnostic criteria and the conservative methodology used for D-la symptom classification. Several pathophysiological mechanisms in ME/CFS were not examined.
CONCLUSIONS
Shared symptomatology and underlying microbiota-gut-brain interactions raise the possibility of a continuum of acute (D-la) versus chronic (ME/CFS) presentations related to D-lactate absorption. Measurement of D-lactate in ME/CFS is needed to effectively evaluate whether subclinical D-lactate levels affect neurological symptoms in this clinical population.
Topics: Acidosis, Lactic; Adult; Child; Fatigue Syndrome, Chronic; Female; Humans; Male
PubMed: 28592308
DOI: 10.1186/s12967-017-1229-1 -
The Journal of International Medical... Jan 2022Type B lactic acidosis is a rare complication of non-tissue perfusion abnormalities caused by solid tumors or hematologic malignancies. Herein, we present the case of a...
Type B lactic acidosis is a rare complication of non-tissue perfusion abnormalities caused by solid tumors or hematologic malignancies. Herein, we present the case of a 42-year-old man with type B lactic acidosis and hypoglycemia who was found to have a diffuse large B-cell lymphoma. The cause of lactic acidosis and/or hypoglycemia is thought to be the Warburg effect, which is when the metabolic rate of a rapidly growing malignant tumor is very high and dominated by glycolysis. Systemic damage from type B lactic acidosis can occur when the increased rate of glycolysis exceeds the normal muscle and liver lactic acid clearance rate. The Warburg effect is a rare but serious condition that needs to be recognized, not only in diffuse large B-cell lymphoma, but also in other malignancies. The prognosis of lactic acidosis in patients with malignant tumors is very poor. Currently, effective chemotherapy seems to be the only hope for survival.
Topics: Acidosis, Lactic; Adult; Humans; Hypoglycemia; Lactic Acid; Lymphoma, Large B-Cell, Diffuse; Male; Prognosis
PubMed: 34986706
DOI: 10.1177/03000605211067749